吉西他滨联合卡培他滨治疗复发转移性胃癌疗效分析

The short-term effcacy of gemcitabine combined with capecitabine in treatment of 30 cases with advanced gastric cancer

背景与目的:晚期复发转移性胃癌的治疗是临床治疗的一个难点,目前尚无二线治疗的标准方案。本研究通过吉西他滨联合卡培他滨方案,观察其对晚期进展期胃癌的近期疗效、不良反应和临床获益的情况。方法:30例晚期胃癌患者,全组均采用二线以上化疗方案。化疗方案为吉西他滨加卡培他滨。每例完成2个周期以上化疗(2～7个周期),共114个周期。结果:30例患者客观有效率(RR)为20%,疾病控制率(DCR)为80%,进展(PD)占26.7%;中位缓解期4.5个月,中位生存期10.9个月。不良反应主要为骨髓抑制,Ⅲ～Ⅳ度白细胞减少者占33.3%。Ⅲ～Ⅳ度血小板减少者占30.1%,Ⅲ～Ⅳ度手足综合征占8.8%。无一例患者因不良反应而使治疗延期。结论:吉西他滨联合卡培他滨化疗方案二线治疗胃癌有一定疗效,不良反应可耐受,疾病控制率高,对多程化疗失败的晚期胃癌患者不失为一种安全的选择,多数患者可以通过化疗获益。

Background and purpose： The incidence of gastric cancer was ranked as the first common tumor in China. No standard second-line chemotherapy regimens for AGC are available at present. This study was to investigate the efficacy and toxicity of gemcitabine combined with capecitabine as second-line chemotherapy for AGC. Methods： Thirty cases of the patients with either recurrence after chemotherapy or metastatic gastric cancer were enrolled. Gemcitabine was infused 1000 mg/m^2 for 30 minutes dl and d8, capecitabine was oral 1 000 mg/m^2 bid dl-14. The regimen was repeated every 3 weeks. Treatment efficacy was evaluated every 2 cycles. All patients received at least 2 cycles of therapy. Results： Patients received a total of 114 cycles of treatment, and all were evaluable for efficacy and toxicity. The response rate （RR） was 20%. The disease control rate （DCR） was 80%, and 8 cases had progression disease （PD）. The median remission time was 4.5 momths and the median survival time was 10.9 months. The main side-effects were myelosuppression and neurosensory toxicity. Conclusion： Gemcitabine combined with capecitabine regimen is effective in the treatment of advanced gastric cancer as second line treatment. The side-effects are mild.