卡培他宾治疗晚期肝癌临床观察

Treating advanced stage HCC with capecitabine

目的 探讨卡培他宾在晚期肝癌临床治疗中的疗效。方法 将我科收住的34例肝癌病人随机分为两组：①治疗组：希罗达2000mg／m^2，分2次／d 口服、连用14d，休息7d，为一周期，至少用药二周期以上；②对照组：单纯支持治疗，至少6wk。治疗前后查肝肾功能，血常规，AFP，ECG，CT或MRI、B超等。疗效和不良反应按WHO疗效及不良反应评价标准评价，统计分析方法采用x^2检验，P〈0．05为有统计学意义。结果 治疗组：CR无病例，PR2例，SD10例，PD6例；总有效例数2例，总有效率为11．8％，稳定率58．8％。12例AFP增高中5例下降，下降率为41．7％。生存期最短的为3mo，最长的7mo，中位生存期为5．3mo。希罗达最少为2周期，最多6周期，共40周期。对照组：CR无病例，PR无病例，SD2例，PD15例；总有效率为零，稳定率11．8％。11例AFP增高病人中无AFP下降。生存期最短的为1．5mo，最长的4mo，中位生存期为2．3mo。采用x^2检验，P〈0．05，两组有显著的统计学差异。不良反应，治疗组3例恶心、呕吐，3例中性粒细胞减少，3例出现腹泻，皮肤红肿、脱屑等手足综合征，这些副反应均在1乏级。发生最多的是手足综合症，发生率为：29．4％。结论 本组病例说明希罗达2000mg／d，分二次口服，连用14d，休息7d为一周期，在晚期肝癌中的临床应用是可行、安全而有效的。主要不良反应表现为手足综合症，可以对晚期肝癌进一步推广应用。

Objective To evaluate the clinical efficacy of capecitabine in trating advanced stage HCC. Methods 34 patients with advanced stage HCC were randomized into 2 groups： ①treatrnent group： capecitabine, 2 000mg/m^2. bid. po. 14d/cycle, resting 7d; ②control group： BST only, at least 6wk. Function of liver and kidney, AFP, ECG, CT or MRI, B-US were checked just before the experiment. Clinical efficacy and side-effects were evaluated according to WHO standard, x^2 analysis was applied into statistic analysis. Results Treatment group： CR 0, PR 2, SD10, PD 6; total efficacy rate was 11.8%, stable rate reached 58.8%. Sera AFP level of 5/12 dropped, dropping rate was 41.7%. Surviving time ranged from 3mo to 7 mo, MST reached 5.3mo. All patients received 40 cycles of capecitabine （ranged from 2-6 cycles each）. Control group： CR 0, PR 0, SD2, PD 15; total efficacy rate was 0, stable rate reached 11.8%. No sera AFP level dropped. Surviving time ranged from 1 .Smo to 4 mo, MST reached 2.3mo. There was significantly difference of clinical efficacy between 2 groups （P〈0.05）. Side effect of treatment group： 3 cases of nausea and vomiting, 3 cases of neutrophil dropping, 3 cases of diarrhea and hand-foot syndrome. All side-effects were less than Grade II. The top one was hand-foot syndrome, which reached 29.4%. Conclusion Treating advanced stage HCC with capecitabine was with high safety and efficacy. The top common side-effect was hand-foot syndrome. This regiment should be recommended.