重组人血管内皮抑素联合卡培他滨、草酸铂治疗结肠癌肝转移的临床观察

Clinical observation of endostar plus capecitabine and oxaliplatin in liver metastasis of colorectal carcinoma

目的：评价重组人血管内皮抑素（恩度）联合卡培他滨、草酸铂治疗结肠癌肝转移的有效性和安全性。方法：经临床明确诊断的结肠癌肝转移患者16例，均接受恩度联合卡培他滨、草酸铂的治疗。恩度30mg加生理盐水500ml匀速缓慢静脉滴注，d1-d14,间歇14天，重复给药；草酸铂200mg加5％葡萄糖水500ml静脉滴注，d1；卡培他滨每日3000mg分早、中、晚3次口服，d1～d14,休息14天。28天为1周期。以RECIST标准评价近期疗效，以NCICTC3．0评价毒性反应。结果：16例患者均可评价客观疗效和毒副反应。共完成40个周期，平均为2．5个周期，获得CR3例，PR5例，SD3例，PD5例。客观有效率（RR）50．0％（8／16），疾病控制率（DCR）68．8％（11／16），3、4级毒性主要与化疗药物有关，白细胞减少4例，血小板减少1例，恶心呕吐4例。结论：恩度联合卡培他滨、草酸铂治疗结肠癌肝转移的疗效较好，毒性低，安全可靠。

Objective：To observe the efficacy and safety of rb-endostatin injection（endostar） combined with eapecitabine and oxaliplatin in liver metastasis of colorectal carcinoma. Methods：Endostar plus capecitabine and oxaliplatin were administrated to the 16 cases with liver metastasis of colorectal carcinoma confirmed by histopathology or cytopathology. The dosage of 30mg/day of endostar solved in 500ml normal saline was slowly intravenously dropped from day 1 to day 14, repeated after 14 day later. Oxaliplatin（200mg/ time） solved in 500ml 5% GS was intravenously dropped in first day. Capeeitabine （3 000mg/day） was given from day 1 to day 14, and repeated every 28 days. The efficacy was evaluated strictly after 2 cycles according to RECIST criteria. Otherwise safety was evaluated after 1 cycle according to NCI CTC 3.0 version criteria. Results：The 16 patients were all evaluable for efficacy and safety. Totally 40 cycles have completed and average cycle number was 2. 5. Among 16 evaluable cases, there were 3 cases achieved CR, 5 cases were PR, 3 cases SD and 5 cases PD. The objective response rate（RR） was 50% （8/16） and disease control rate （DCR） was 68% （11/16）. The occurrence rate of G3/4 toxicities were low, including neutropenia （4 cases） , thrombocytoponia （ 1 case） and nausea/ vomiting（4cases）. These toxicities were mainly related with the chemotherapy agents. Conclusion：There are better efficacies of endostar combined with capecitabine and oxaliplatin in liver metastasis of colorectal carcinoma. The combination regimen was low toxic and tolerable.