CPT-11联合卡培他滨治疗晚期胃癌

Combination of CPT-11 and capecitabine in the treatment of advanced gastric cancer

背景与目的：胃癌是我国最常见的恶性肿瘤，早期诊断率很低，多数患者即使能够手术治疗．术后复发率也很高，胃癌是对化疔相对敏感的消化系统肿瘤，可是迄今缺乏公认的规范的高效方案，因此，歼发新的药物、设计新的方案已成为胃癌研究的热点。本研究的日的是观察CPT-11联合卡培他滨（希罗达）治疔晚期胃癌临床效果及毒副反应。方法：2004年5月—2006年5月，我科用CPT-11及卡培他滨联合治疗晚期胃癌，资料完整可供分析的共计20例。CPT-11 120mg／斫滴注第1．8天；卡培他滨1000mg／m^2分两次口服第1～14天；每3周为一个周期，至少化疗两个周期。结果：20例患者中15例患者肿瘤获得控制，其中CR1例；PR 8例；SD6例：PD5例，总有效率为45％（9／20）；临床肿瘤控制率为75．0％（15／20）。毒副反应主要为血液学毒性（52．1％）及消化道反应（35．2％），且均仅为Ⅰ／Ⅱ度。结论：CPT—11联合卡培他滨治疗晚期胃癌疗效佳．毒副反应轻，尤其适用于体质差，高龄及其他治疗失收患者。

Background and purpose： Gastric cancer is one of the common malignancies seen in our country, mnst patients were diagnosed at a late stage. Surgery remains as one of the main treatments for the patients but the local local and regional failures were still high. The importance of the role of chemotherapy and radiotherapy has been investigated in the treatment of gastric cancer. We evaluated the efficacy and side-effects of CPT-11 combined with capecitabine for the treatment of advanced gastric cancer. Methods： Since May 2004 to May 2006, twenty patients with pathologically proved gastric cancer have been treated by CPF-11 plus capecitahine in our hospital. The regimen consisted of CPT-11 120 mg/m^2 infusion at 1st day and 8th day, capecitabine 1000 mg/（ m^2· d） twice a day frnm 1st-14th day . The cycles were repeated every. three weeks. All the patients were planned to receive at least 2 cycles of chemotherapy. Results： In 20 evaluable patients, 1 case had complete response; 8 case had partial response; 6 case had stable disease aud 5 case with prugressive disease. The response rate of the whole group was 45.0% （9/20） ; Clinical tumor control rate was 75.0% （ 15/20）. The major tuxicities were bone marrow suppression （52.1%） and reactions relative to digestive system （ 35, 2%）. All uf complications were RTOG Ⅰ/Ⅱ degree. Conclusions： Combination of CPT-11 and eapecitabine is effective for advanced gastric cancer and well tolerated by the patients. For the patients with either old age, poor general status or relapse after other chemotherapeutic regimen, the regimen could be the one of choice.