卡培他滨联合甲酰四氢叶酸钙和奥沙利铂治疗晚期结直肠癌的临床观察

Capecitabine in combination with leucovorin and oxaliplatin as adjuvant chemotherapy in the treatment of advanced colorectal cancer

目的:观察卡培他滨(CAPE)联合甲酰四氢叶酸钙(LV)和奥沙利铂(OXA)化疗方案(CAPE-LV-OXA)治疗晚期结直肠癌(CRC)的临床疗效和不良反应。方法:晚期CRC患者39例接受CAPE-LV-OXA方案治疗,每日口服LV90mg/d及CAPE 2000-2500mg/(m2.d),d1-14;OXA 135mg/m2,静脉滴注2h,d1;每3周为1个疗程。2-6个疗程后观察疗效及不良反应。结果:39例患者使用CAPE-LV-OXA方案化疗共122疗程,中位疗程数为3.8。可评价疗效37例,完全缓解0例,部分缓解19例,稳定11例,进展7例,有效率(RR)为51.4%(19/37),中位进展时间(TTP)为5.6(2-13)月,中位生存时间(MST)为11.3(3-27)月。不良反应主要为胃肠道反应、骨髓抑制、神经毒性、手足综合征等,多为Ⅰ-Ⅱ度,Ⅲ度不良反应5例,对症治疗或停止治疗后可缓解。无化疗相关死亡者。结论:化疗方案(CAPE-LV-OXA)在CRC的治疗中疗效较为肯定,耐受性良好,具有较好的依从性。

Objective：To evaluate the efficacy and toxicity of capecitabine in combination with leucovorin and oxaliplatin regimen （ CAPE - LV - OXA） as the adjuvant chemotherapy in the treatment of patients with advanced colorectal cancer. Methods ： Thirty - nine patients with advanced/metastatic colorectal cancer were enrolled in the study. Patients were administrated with oral capecitabine 2000 -2500 mg/（ m^2 · d ）, d1-14, and oral leucovorin 90 mg/d , d1-14, ,and intravenous oxaliplatin 135 mg/m^2 ,d1, in a 21 - day cycle regimen for 2 - 6 cycles. Results：Thirty - seven patients were evaluable for efficacy and toxicity. There was no complete response, 19 patients had partial responses ,with an overall response rate of 51.4%. The TTP was 5.6 months （ range 2 - 13 months） ,The median survival time was 11.3 months（ range 3 -27 months）. Therapy was generally well tolerated, the most common adverse effects were gastrointestinal response, neutropenia, neurosensory toxicity, hand foot syndrome. There was no chemotherapy-related death. Conclusion ： CAPE - LV - OXA regimen is an effective and well tolerated chemotherapy regimen for advanced colorectal cancer.