卡培他滨在低位直肠癌新辅助治疗中的应用  

Application of Capecitabine in Neoadjuvant Therapy for Low Rectal Carcinoma.

作　　者：郁宝铭[1] 吴唯勤[1] 邬宇飞[2] 

机构地区：[1]上海第二医科大学附属瑞金医院外科上海消化外科研究所,200025 [2]上海第二医科大学附属瑞金医院卢湾分院外科,200025

出　　处：《外科理论与实践》2003年第3期184-186,共3页Journal of Surgery Concepts & Practice

摘　　要：目的:本文旨在探索卡培他滨(希罗达)联合放疗在低位直肠癌新辅助治疗中可能发挥的作用。方法:对30例T3、T4期低位直肠癌病例随机分为二组进行手术前化、放疗。化疗药物选用卡培他滨,A组用2500mg/(m^2/d),分二次口服,服用14天停7天,直至手术;B组采用1250mg/(m^2/d),分二次口服,连续服用至手术;放疗二组相同,每周5天,每次200cGy,共4周20次,三野照射,总剂量40Gy,休息4～6周进行手术。结果:全部完成根治性切除术,24例(80％)保留了肛门;临床和病理证实CR 8例(26.67％),PR 14例(46.67％);有效率(RR)73.3％,A组为63.3％,B组83.33％。化、放疗引起的副反应绝大部分属1～2级,发生最多的为手足综合征(23.33％),A组发生率明显高于B组。结论:卡培他滨联合放疗用于新辅助治疗是合理、可行、安全而有效的,值得进一步临床推广。Objective: To explore the effect of Capecitabine in neoadjuvant therapy for low rectal carcinoma. Methods: Thirty cases of Stage T3/T4 of low rectal carcinoma were randomized into 2 groups. In Group A chemotherapy by Capecitabine 2 500mg/(m2.d) (divided into two doses) for 14 days, followed by 7 days of rest as a cycle, until surgical operation; and in group B, Capecitabine 1 250mg/(m2.d) was given by oral without any rest until operation. In all the cases, radiotherapy with a total dose of 40 Gy was given (20 fractions of 2Gy, 5 d in a week over a period of 4 weeks, followed by surgery 4 to 6 weeks later. Results: All the patients underwent curative resection successfully following neoadjuvant therapy, with 24 patients by Sphincter-saving resection (SSR) (80%). As a results of clinical pathologically, 8 cases were proved to be CR (26.67%), and 14 cases PR(46.67%). The overall response rate was 73.33%, 63.63% in Group A and 83.33% in Group B. Mild side-effects of degree 1-2 were observed in the majority of cases.H-foot syndrome being the most commonly occurring (23.3%). The incidence of side-effects being higher in Group A than in Group B. Conclusions: Capecitabine combined with radiation as neoadjuvant therapy is rational, feasible, safe and effective for improving of the therapeutic results in stage T3/T4 rectal carcinoma.

关 键 词：低位直肠癌 卡培他滨 新辅助治疗 卡培他滨 放射治疗 

分 类 号：R735.37[医药卫生—肿瘤]