羟基喜树碱联合草酸铂治疗晚期消化道肿瘤的临床疗效

Short-term effects of chemotherapy with combination of hydroxycamptothecine and oxaliplatin in the treatment of advanced digestive tract cancers

目的观察羟基喜树碱(HCPT)联合草酸铂(LOHP)方案治疗晚期消化道肿瘤的近期疗效和毒副反应。方法46例晚期消化道肿瘤患者采用HCPT+LOHP方案治疗,LOHP130mg/m2+5%葡萄糖500ml,滴注3h,第1天;HCPT6mg/m2+生理盐水500ml,连续滴注6h,第1～4天,每天1次,首次于LOHP后给药;21d为1个周期。每例治疗2个周期后进行临床疗效和不良反应评定。在30例可评价疗效患者中,胃癌8例,大肠癌20例,胆囊癌1例,腹腔恶性纤维组织细胞瘤1例,共计61个化疗周期;另16例的16个化疗周期仅统计毒性反应。结果完全缓解(CR)1例,部分缓解(PR)11例,稳定(SD)16例,进展(PD)2例,总有效率(CR+PR)为40.0%(12/30)。化疗后发生白细胞减少34个周期,占44.2%,其中Ⅲ～Ⅳ度白细胞下降19个周期,占55.9%;腹泻42个周期,占54.5%,其中Ⅲ～Ⅳ度腹泻20个周期,占47.6%。结论HCPT联合LOHP治疗晚期消化道肿瘤有较高的近期疗效,特别对一线化疗复发的大肠癌患者有较好的疗效,其主要副作用是白细胞下降和腹泻。

Objective To evaluate the short-term therapentic effects and side effects of combined hydroxycamptothecine and oxaliplatin in the treatment of advanced digestive tract cancers. Methods Thirty patients saffering from advanced digestive tract tumors including gastric cancer 8, colorectal cancer 20, cholecystic cancer 1 and malignant fibroadenoma 1 were studied. They were treated with hydroxycamptothecine plus oxaliplatin for 2 cycles with interval of 21 days. Results The complete response, partial response, stable disease and progressive disease rates were 3.3%(1/30),36.7%(11/30),53.3% (15/30)and 6.7%(3/30) respectively with an overall response rate (CR+PR) of 40.0%(12/30)。In the whole 77 cycles, leukocytopenia was observed in 34 cycles (44.2%) and 19 cycles(55.9%) at grades Ⅲ and Ⅳ. Diarrhea developed in 42 cycles(54.5%) and 20 cycles(47.6%) grades Ⅲ and Ⅳ. The other side effects were fever, alopecia, nausea and vomiting, constipation, hepatic and renal function abnormity and neuritis. Conclusion Satisfactory response rate is obtainable in advanced colorectal cancer as treated by hydroxycamptothecine plus oxaliplatin. The toxicity consists of sevene leukocytopenia and diarrhea.