奥沙利铂联合替吉奥二线治疗晚期胆囊癌的临床效果  

Clinical effect of Oxaliplatin combined with S-1 as second-line chemotherapy for advanced biliary tract cancer

作　　者：牛楠[1] 刘佳[2] 吴荣[1] 曾越灿[1] 

机构地区：[1]中国医科大学附属盛京医院第二肿瘤科,辽宁沈阳110022 [2]辽宁省肿瘤医院妇产科,辽宁沈阳110042

出　　处：《中国医药导报》2016年第18期142-145,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(81201803)

摘　　要：目的观察奥沙利铂联合替吉奥二线治疗晚期胆囊癌的临床效果及安全性。方法选取2011年6月~2015年6月在中国医科大学附属盛京医院住院治疗的40例吉西他滨化疗后出现进展的经病理组织学证实的晚期胆囊癌患者,根据治疗方法不同,分为治疗组和对照组各20例。治疗组给予奥沙利铂联合替吉奥,替吉奥胶囊40 mg/m2,每天2次,餐后口服,d1~d14;奥沙利铂130 mg/m2,静脉滴注3 h,d1。对照组给予替吉奥口服化疗,替吉奥40 mg/m2,每天2次。两组均以治疗28 d为1个周期,完成至少2个周期治疗后评价疗效及安全性,直至疾病进展或毒性不能耐受,最多治疗6个周期。观察两组疾病临床治疗效果及不良反应情况。结果近期临床疗效比较:治疗组总有效率及总疾病控制率高于对照组,差异有统计学意义(P<0.05)。远期疗效比较,治疗组中位疾病进展时间及中位总生存时间均长于对照组,差异有统计学意义(P<0.05)。治疗组粒细胞减少及皮疹发生率明显高于对照组,差异有统计学意义(P<0.05),经对症治疗后均得到有效缓解。结论奥沙利铂联合替吉奥较单药替吉奥治疗晚期胆囊癌效果优,值得临床推广应用。Objective To observe the efficacy and safety of Oxaliplatin combined with S-1 monotherapy as second-line chemotherapy for advanced biliary tract cancer. Methods 40 patients with pathologically proven advanced biliary tract cancer who had shown disease progression while receiving GEM-based chemotherapy in Shengjing Hospital of China Medical University from June 2011 to June 2015 were selected. According to the treatment method, patients were divided into two groups, each group had 20 cases. Patients in the treatment group were given S-1 capsule 40 mg/m2 twice a day, oral after meal, d_1-d_（14）; Oxaliplatin 130 mg/m^2, intravenous drip for 3 h, d1. Patients in the control group were given S-1 orally, 40 mg/m2 twice a day. The two groups were all taken 28 d as a cycle. Therapeutic effects and safety were evaluated after 2 cycles of treatment at least, until disease progression or toxicity intolerance, most treatment for 6 cycles. The clinical therapeutic effects and adverse reaction of the two groups were observed. Results The recent clinical curative effect comparison showed that the total effective rate and the total disease control rate in the treatment group were higher than those of the control group, with statistically significant differences（P〈 0.05）. The long-term curative effect comparison showed that the median of time to progression and overall survival in the treatment group were longer than those of the control group, with statistically significant differences（P〈 0.05）. Incidence of granulocytopenia and rash in the treatment group were higher than those of the control group, with statistically significant differences（P〈 0.05）, after symptomatic treatment all were effectively relieved. Conclusion The effect of Oxaliplatin combined with S-1 for advanced biliary tract cancer is better than S-1 monotherapy, which is worthy of clinical popularization and application.

关 键 词：替吉奥 奥沙利铂 胆囊癌 晚期 吉西他滨 最佳支持治疗 

分 类 号：R979.1[医药卫生—药品] R735.8[医药卫生—药学]