替吉奥联合奥沙利铂方案治疗晚期小肠腺癌的临床观察  

S-1 plus oxaliplatin for the treatment of advanced small bowel adenocarcinoma

作　　者：张慧卿[1] 何波[1] 芦珊[1] 王艳华[1] 宋荣峰[1] 万以叶[1] 

机构地区：[1]江西省肿瘤医院内三科,江西南昌330029

出　　处：《中国癌症杂志》2014年第1期46-51,共6页China Oncology

摘　　要：背景与目的：化疗是晚期小肠腺癌的主要治疗手段，目前尚无标准治疗方案。本研究旨在评估替吉奥联合奥沙利铂治疗晚期小肠腺癌的疗效与安全性。方法：收集29例经替吉奥联合奥沙利铂治疗的晚期小肠腺癌患者的临床资料，并进行回顾性分析。化疗方案：第l天，静脉滴注奥沙利铂130mg／m^2；第1～i4天，口服替吉奥40mg／m^2，每日2次，21d为1个周期。结果：患者完成中位化疗周期数4（2-9）个，均可评估疗效，其中完全缓解（completeresponse，CR）2例（6．9％），部分缓解（partialresponse，PR）9例（31．0％），客观有效率（responserate，RR）为37．9％，疾病控制率（diseasecontrolrate，DCR）为65．5％。无～例患者失访，中位随访时间为14．7个月。患者中位无进展生存时间（progreSSfreesurvival，PFS）为5．4个月（95％CI：3．6～7．2），中位总生存时间（overal1survival，OS）为13．2个月（95％CI：6．7-19．7）。亚组分析显示，替吉奥联合奥沙利铂方案非一线化疗、体力状况（EasternCooperativeOncologyGroup，ECOG）评分〉1分，转移部位〉2个的患者中位0s明显缩短（P〈O．05）。化疗的主要不良反应为骨髓抑制、胃肠道反应、乏力、周围神经病变和皮疹，以轻度为主，均可耐受。结论：本研究，结果显示，替吉奥联合奥沙利铂治疗晚期小肠腺癌有效率高、耐受性好，值得进一步研究。Background and purpose： Small bowel adenocarcinoma （SBA） is uncommon, and frequently diagnosed at late stage. Chemotherapy is the main treatment method for advanced SBA. Despite recent progress in SBA therapy, no standard regimen has been established up to now, and new active regimen is expected to improve the outcome of this disease. The purpose of this study was to evaluate the efficacy and safety of S-l/oxaliplatin for the treatment of advanced SBA. Methods： In a retrospective study, clinical characteristics and outcomes of 29 patients with advanced SBA were collected and analyzed. Patients received oral S-1 40 mg/m2, twice daily, dl-14, oxaliplatin was administered intravenously 130 mg/m2 on the first day of every cycle, repeated every 3 weeks, Efficacy and toxicity were evaluated after at least two consecutive cycles. Results： All patients were evaluated for efficacy and safety. The objective response and disease control rates were 37.9% and 65.5%, respectively. The median progression-free survival and overall survival were 5.4 months （95%CI： 3.6-7.2） and 13.2 months （95%CI： 6.7-19.7）, respectively. In univariate analysis, the following factors were significantly associated with poor outcome： not first line chemotherapy setting, ECOG performance status〉l and sites of metastasis〉2 （Log-rank, P〈0.05）. The treatment related adverse events were mild and manageable. Myelosuppression, gastrointestinal reaction, fatigue, sensory neuropathy and rash were the most common toxicities. Conclusion： This study was the first to report the efficacy of S-1 combined with oxaliplatin for advanced SBA. S-1/oxaliolatin may be effective and safe for advanced SBA and worthy of further study.

关 键 词：晚期小肠癌 化疗 替吉奥 奥沙利铂 

分 类 号：R735.32[医药卫生—肿瘤]