卡培他滨单药改良方案治疗老年晚期胃癌临床研究

Capecitabine improved regimen as first-line treatment in elderly patients with advanced gastric cancer

目的:观察卡培他滨作为一线药物改良方案治疗老年晚期胃癌的疗效及安全性。方法:对92例老年晚期胃癌患者采用卡培他滨2500mg/(m2.d),分早晚2次服用,每3周重复共用4个周期。治疗1～2个周期出现Ⅲ～Ⅳ血液学毒性或消化道毒性者38例作为观察组,调整卡培他滨用药间歇2500mg/(m2.d),分早晚2次服用,连服7d,休7d,再服7d,28d为1个周期,共用>4个周期。休息1个月评定疗效。结果:观察组38例患者中CR2例、PR9例、SD15例和PD12例,缓解率(CR+PR)为28.94%,肿瘤控制率(CR+PR+SD)为68.42%。与对照组疗效比较,差异无统计学意义,P>0.05。主要毒副反应为厌食、恶心、呕吐、腹泻、手足综合征、皮肤色素沉着、白细胞减少、转氨酶升高等。毒副反应轻微,多为Ⅰ/Ⅱ级。结论:卡培他滨作为一线药物治疗老年或体质差的晚期胃癌患者即使改良方案也有较好的疗效,毒副反应轻。

OBJECTIVE：To evaluate the objective response rate and toxicity of Capecitabine regimen as first-line therapy for elderly patients with advanced gastric cancer.METHODS：A total of 92 patients with advanced gastric cancer were administrated with oral capecitabine 2 500 mg/（m2·d）,2 times everyday in morning and evening separately,in a 21-day cycle of therapy for 3 cycles.After 1-2 treatment cycles 38 patients with Ⅲ-Ⅳ hematology toxic or gastrointestinal tract toxicity were adjusted capecitabine 2 500 mg/（m2·d）,2 times everyday in morning and evening separately,used for 7 days and rest for 7 days,in a 28 days cycle of therapy for 4 cycles.RESULTS：A total of 38 patients were assessable for efficacy and toxicity.2 patients CR,9 patients PR,15 patients SD,12 patients PD,with an response rate（CR＋PR）of 28.94% and tumor control of（CR＋PR＋SD）for 68.42%.The effect was not statistically significant differences in the two groups（P0.05）.The most common adverse effects were gastrointestinal response and myelosuppression and most were Ⅰ/Ⅱ degree.There was no chemotherapy-related death.CONCLUSION：The capecitabine improved regimen is effective and well tolerated as first-line therapy for old patients with advanced gastric cancer.