白蛋白紫杉醇联合卡培他滨方案二线治疗晚期胆系恶性肿瘤的回顾性研究  

Nab-paclitaxel combined with capecitabine as second-line treatment in patients with advanced biliary tract cancer:A retrospective study

作　　者：郑怡[1] 赵鹏[1] 刘璐璐[1] 童舟[1] 张航瑜 傅琦涵 朱旭东 方维佳[1] Zheng Yi;Zhao Peng;Liu Lulu;Tong Zhou;Zhang Hangyu;Fu Qihan;Zhu Xudong;Fang Weijia(Department of Medical Oncology,the First Affi liated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China)

机构地区：[1]浙江大学医学院附属第一医院肿瘤内科,浙江杭州310003

出　　处：《实用肿瘤杂志》2023年第4期340-346,共7页Journal of Practical Oncology

基　　金：浙江省自然科学基金(LY21H160029)。

摘　　要：目的观察AX方案(白蛋白紫杉醇联合卡培他滨)二线治疗转移性/不可手术的晚期胆系恶性肿瘤(advanced biliary tract cancer,aBTC)患者的有效性和安全性。方法选取2020年4月至2022年4月在浙江大学医学院附属第一医院肿瘤内科使用AX方案二线治疗的aBTC患者52例。回顾性分析其生存情况和不良反应,并采用单因素和多因素Cox回归分析研究影响患者预后的相关临床特征。结果52例aBTC患者经AX方案二线治疗后,完全缓解1例,部分缓解9例,客观缓解率为19.2%,疾病控制率为63.5%,中位无进展生存期为4.3个月(95%CI:2.2~6.4个月),中位总生存期为8.8个月(95%CI:7.2~10.4个月)。发生率>10%的治疗相关3~4级不良反应包括白细胞细胞减少(15.4%)和外周神经毒性(21.2%)。多因素分析表明,血清白蛋白和糖类抗原19-9水平均是aBTC患者AX方案二线治疗后无进展生存期和总生存期的独立危险因素(均P<0.05)。结论AX方案作为aBTC的二线治疗方案具有较好的疗效和安全性,血清白蛋白和糖类抗原19-9水平具有一定的预后价值。Objective To assess the efficacy and safety of nab-paclitaxel combined with capecitabine(AX)regimen as second-line treatment in patients with advanced biliary tract cancer(aBTC).Methods From April 2020 to April 2022,52 aBTC patients who received second-line treatment with AX regimen in the department of medical oncology of the First Affiliated Hospital of Zhejiang University School of Medicine were selected.Their survival and adverse reactions were analyzed retrospectively.Univariate and multivariate Cox regression analysis of clinicopathological features related to the prognosis of patients was performed.Results Among the 52 aBTC patients receiving second-line treatment with AX regimen,one patient had complete response and 9 had partial response,with an objective response rate of 19.2%,a disease control rate of 63.5%,a median progression-free survival(PFS)of 4.3 months(95%CI:2.2-6.4 months),and a median overall survival(OS)of 8.8 months(95%CI:7.2-10.4 months).The most common(>10%)grade 3 or 4 treatment-related adverse effects were leukopenia(15.4%)and peripheral neurotoxicity(21.2%).Multivariate analysis showed that serum albumin and carbohydrate antigen 19-9(CA19-9)levels were both independent risk factors for PFS and OS in aBTC patients receiving second-line treatment with AX regimen(all P<0.05).Conclusions AX regimen as second-line treatment for aBTC patients has good efficacy and safety,and serum albumin and CA19-9 levels have a certain prognostic value.

关 键 词：胆系恶性肿瘤 白蛋白紫杉醇 卡培他滨 二线治疗 

分 类 号：R735[医药卫生—肿瘤]