HELF方案联合干扰素治疗晚期胆囊癌的临床研究

Clinical study of HELF regimen combined with α-interferon in the treatment of advanced gallbladder carcinoma

目的:观察HELF方案联合干扰素治疗晚期胆囊癌的临床疗效和毒副反应。方法:24例晚期胆囊癌患者,应用HELF方案化疗,即HCPT6mg/m2、VP1660mg/m2、CF200mg/m2和5Fu500mg/m2,均为静脉滴注,第1～5天;其中前13例化疗同时给予α干扰素(αIFN)300万单位肌肉注射,1次/隔日,连用3个月以上,因药源性发热、骨髓抑制等毒副反应发生率较高,后11例患者更改为化疗结束后第2天给予αIFN300万单位肌肉注射,1次/日,连用10天。化疗每4周为1周期,2周期后按照WHO标准进行疗效及毒副反应评价。结果:24例均可以进行疗效评价,获得CR1例,PR5例,SD12例,PD6例,总有效率为25%,中位生存期17个月。毒副反应主要为骨髓抑制、脱发和药源性发热等。结论:HELF方案联合αIFN治疗晚期胆囊癌疗效较好,毒副反应小,患者耐受性好,序贯应用HELF方案及αIFN可以减轻毒副反应。

Objective：To observe the efficacy and side effects of HELF regimen combined with α-interferon in the treatment of advanced gallbladder carcinoma. Methods：24 cases with advanced gallbladder carcinoma were administrated with HELF regimen,6mg/ m^2 of HCPT,60mg/m^2 of VP16,200mg/m^2 of CF and 500mg/m^2 of 5-Fu were infused intravenously on day 1 to 5. 3 million units of α -interferon was intramuscular injected every other day for at least 3 months in the former 13 cases, and administrated continuously on d1 10 after chemotherapy in the latter 11 cases because of myelosuppression and temporary drug fever. The regimen was repeated every 4 weeks and the efficacy was evaluated using WHO standard after 2 cycles of treatment. Results：All of the 24 cases were eligible for clinical response evaluation. The overall response rate was 25% ,including 1 case of CR,5 cases of PR,12 cases of SD and 6 cases of PD respectively. The median survival time was 17 months. The major side effect were myelosuppression,alopecia and temporary drug fever. Conclusion：HELF combined with α-interferon is a nice regimen,meanwhile the toxicity is mild and tolerable. The sequential administration of HELF and α-interferon could reduce the incidence of side-effects.