吉西他滨不同给药方案联合奥沙利铂治疗复发转移性胆管癌的临床观察  

Clinical Observation of Different Gemcitabine Dosage Regimens Combined with Oxaliplatin in the Treatment of Recurrent Metastatic Cholangiocarcinoma

作　　者：吴燕丽[1] 曾晖[1] 王智勇[1] 

机构地区：[1]武汉大学中南医院,武汉430071

出　　处：《中国药房》2017年第27期3794-3797,共4页China Pharmacy

摘　　要：目的:观察吉西他滨不同给药方案联合奥沙利铂治疗复发转移性胆管癌的疗效和安全性。方法:100例复发转移性胆管癌患者随机分为A组(50例)和B组(50例)。A组患者给予注射用吉西他滨1 000 mg/m2,d1、8,固定静脉滴注30 min+注射用奥沙利铂130 mg/m2,d1,静脉滴注。B组患者给予注射用吉西他滨1 000 mg/m2,d1、8,固定输注速率10 mg/(m2·min)+注射用奥沙利铂(用法用量同A组)。两组均以3周为1个疗程,至少行2个疗程治疗。观察两组患者的临床疗效及不良反应发生情况;随访3年,观察两组患者总生存时间和无进展生存时间。结果:两组患者均至少完成2个疗程治疗。B组患者客观缓解率、疾病控制率均显著高于A组,总生存时间、无进展生存时间均显著长于A组,但B组患者Ⅲ~Ⅳ级血小板下降发生率、白细胞下降发生率均显著高于A组,差异均有统计学意义(P<0.05)。结论:吉西他滨固定输注速率给药方案联合奥沙利铂用于复发转移性胆管癌患者在控制病情进展、延长生存时间、改善远期预后方面均显著优于吉西他滨固定滴注时间给药方案,但用药后可能会增加血液相关不良反应的发生风险。OBJECTIVE： To observe therapeutic efficacy and safety of different gemcitabine dosage regimens combined with oxaliplatin in the treatment of recurrent metastatic cholangiocarcinoma. METHODS： A total of 100 patients with recurrent metastat- ic cholangiocarcinoma were randomly divided into group A（50 cases） and B（50 eases）. Group A was given Gemcitabine hydrochlo- ride for injection 1 000 mg/m^2,dl.8, for fixed drip time 30 min＋Oxaliplatin for injection 130 mg/m^2, dr, intravenously. Group B was given gemcitabine 1 000 mg/m^2, dl.8,with fixed infusion speed of 10 mg/（m^2.min）＋ Oxaliplatin for injection （same usage and dos- age as group A）. A treatment course lasted for 3 weeks, and both groups received 2 courses. Clinical efficacies and toxic reaction of 2 groups were observed, and total survival time, progression-free survival time of 2 groups were followed up for 3 years. RE- SULTS.. Both groups completed at least 2 courses of treatment. The objective remission rate and disease control rate of group B were significantly higher than those of group A; total survival time and progression-free survival time of group B were significantly longer than those of group A. The incidence of IH-IV degree thrombocytopenia and leucopenia in group B were significantly higher than group A, with statistical significance （P〈0.05）. CONCLUSIONS： Gemcitabine dosage regimen of fixed infusion speed com- bined with Oxaliplation is better than Gemcitabine dosage regimen of fixed drip time for recurrent metastatic cholangiocarcinoma pa- tients in controlling the disease progression, prolonging the survival time and improving the long-term prognosis, but may increase the risk of blood related ADR.

关 键 词：吉西他滨 固定滴注时间 固定输注速率 胆管癌 复发转移性 疗效 安全性 

分 类 号：R735.8[医药卫生—肿瘤]