晚期结直肠癌联合化疗后卡培他滨维持治疗的临床评价  

Efficacy and tolerance of maintenance therapy in patients with incurable advanced colorectal cancer

作　　者：杨冬阳[1] 黎莹[1] 刘建化[1] 江韦韦[1] 马冬[1] 

机构地区：[1]广东省人民医院肿瘤中心肿瘤内科,广东广州510080

出　　处：《南方医科大学学报》2013年第12期1815-1818,1830,共5页Journal of Southern Medical University

基　　金：广东省科技计划项目(2011B031800285)

摘　　要：目的：评价晚期结直肠癌患者联合化疗后卡培他滨维持治疗的临床疗效、安全性、可行性。方法采用回顾性研究方法，分析我科2009年5月~2012年12月住院治疗的73例晚期结直肠癌连续病例，均采用含氟尿嘧啶类联合奥沙利铂或伊立替康化疗。肿瘤达到化疗最大缩小率后，其中42例给予单药卡培他滨1000 mg/m2 bid＊14 d/3周的维持治疗至不能耐受或进展；另31例停止化疗随访观察。使用Kaplan-Meier分析两组的疗效，χ2检验分析安全性。结果卡培他滨维持治疗的42例中位PFS为11.6月（95%CI：10.22~11.78），联合化疗的有效率（RR）：42.8%。31例停止化疗病例对照观察中位PFS为7.4月（95%CI：5.79~8.21），联合化疗的RR：38.7%。两组RR相似但PFS疗效有统计学差异（P0.05）。结论通过卡培他滨维持治疗的晚期结直肠癌患者得到较长的PFS，且耐受性好，保留了再次进展后接受强烈化疗的可能性，为提高晚期结直肠癌患者生存获益和生活质量提供基础，同时提供了一种有效并有良好耐受性的治疗模式，具有进一步研究探索的可行性和临床前景。Objective To evaluate efficacy, safety, and feasibility of maintenance therapy with capecitabine after fluoropyrimidines/oxaliplatin or fluoropyrimidines/irinotecan chemotherapy in patients with incurable colorectal cancer. Methods Seventy-three hospitalized patients with incurable colorectal cancer who received fluoropyrimidines/oxaliplatin or fluoropyrimidines/irinotecan as the first-line chemotherapy between May 2009 and December 2012 in our department were retrospectively analyzed. When the maximum percentage tumor size reduction was achieved, 42 patients received a maintenance therapy with capecitabine at 1000 mg/m2 in two daily doses on days 1-14, and the other 31 patients without further chemotherapy or the maintenance therapy were followed up. The treatment was repeated every 3 weeks as a cycle until disease progression or intolerable toxicity. The efficacy and safety were evaluated by Kaplan-Meier analysis and χ2 analysis. Results The 42 patients receiving capecitabine maintenance therapy achieved a median progression free survival （PFS） of 11.6 months （95%CI 7.8-15.4）, significantly longer than the PFS of 7.4 months （95% CI 4.9-11.8） in the 31 patients without the maintenance therapy （P0.05） except for hand-foot syndrome. Conclusion In patients with incurable colorectal cancer, capecitabine maintenance therapy following combined chemotherapy can achieve a prolonged PFS with a good safety and tolerance and retains the possibility of further intense therapy in the event of disease progression.

关 键 词：晚期结直肠癌 卡培他滨 维持治疗 耐受性 

分 类 号：R735.3[医药卫生—肿瘤]