希罗达加奥沙利铂治疗晚期贲门癌46例

Treatment of gastric cardia cancer with capecitabine and oxaliplatin:an analysis of 46 cases

目的:初步探索该联合方案一线治疗晚期贲门癌的效果.方法:收集经组织学或细胞学证实的贲门癌患者46例,ECOG PS为0、1、2的患者分别有11、21、14例.所有患者器官功能正常,给予Oxaliplatin 130mg/m2,iv,第1天,Capecitabine 1000mg/m2,po,每天2次,第1-14天,21d为一周期,分析患者有效率(RR)、疾病进展时间(TTP)、总生存时间(OS)和不良反应.结果:46例患者RR为45.7%(95%CI:39.1%-60.9%),包括CR4例(8.7%),PR17例(37.0%),TTP为9mo(95%CI:5.2-12.8),OS为15mo(95%CI:7.6-22.4).目前有34例患者死亡,无化疗相关死亡.3度不良反应包括恶心/呕吐2例、腹泻2例、外周感觉神经症状2例,手足综合征和中性粒细胞缺乏各2例.结论:XELOX联合方案一线治疗晚期食管腺癌、食管胃连接处癌和胃贲门癌有效,其毒副反应可以耐受.

AIM： To investigate efficacy of capecitabine in combination with oxaliplatin in treating advanced gastric cardia cancer. METHODS： Forty-six patients with histologically or cytologically confirmed advanced gastric cardia cancer were retrospectively analyzed. Eastern Cooperative Oncology Group performance statuses of 0, 1 and 2 were 11, 21 and 14 cases, respectively. All had adequate organ function. All of the patients were prescribed oxaliplatin 130 mg/m^2 intravenously on day I and capecitabine 1000 mg/m^2 orally twice a day, on days 1-14 of a 21-day cycle. The response rate （RR）, time to progression （TTP） and overall survival （OS） of patients were analyzed. RESULTS： The tumor response rate was 45.7%（95% CI： 39.1% to 60.9%）, including 4 cases of complete response （8.7%）and 17 cases of partial response （37.0%）, respectively. Mean time to tumor progression was 9 months （95% CI： 5.2-12.8）, and average survival time was 15 months （95% CI： 7.6-22.4）. To date, there had been 34 deaths all irrelevant to chemotherapy. Notable grade 3 events from the entire cohort included nausea/ vomiting （2 patients）, diarrhea （2 patients）, peripheral sensory neuropathy （2 patients）, hand and foot syndrome （2 patients） and neutropenia （2 patients）. CONCLUSION： First-line treatment of oxaliplatin in combination with capecitabine for advanced adenocarcinoma of the esophagus, gastroesophageal junction and for gastric cardia cancer is effective. This regimen yields an acceptable toxicity profile and merits further study.