卡培他滨治疗晚期结直肠癌发生手足综合征与疗效的观察

Study on Correlation between Curative Effect and Hand-foot Syndrome Induced by Capecitabine as a Therapy to Advanced Colorectal Cancer

目的探讨含卡培他滨联合方案一线治疗不可切除晚期结直肠癌所致手足综合征的发生率及与疗效的关系。方法回顾性分析我科39例使用含卡培他滨双药联合方案一线治疗晚期结直肠癌的临床资料,其中32例接受卡培他滨加奥沙利铂化疗,7例使用卡培他滨加伊立替康化疗。结果 39例患者中发生1度、2度和3度手足综合征分别占35.9%、17.9%和7.7%,出现手足综合征的客观有效率为45.8%;未出现手足综合征病例的客观有效率为13.3%,P=0.024;疾病控制率分别为75%和40%,有改善疾病控制的趋势,P=0.065。结论手足综合征是卡培他滨治疗结直肠癌的主要剂量限制性毒性,出现HFS者提示有效率可能增大,但需要更多的临床研究进一步验证。

Objective To investigate the correlation between curative effect and incidence of hand-foot syndrome （HFS） induced by capecitabine in combination with other agents as a therapy to unresectable advanced coloreetal cancer. Methods A retrospective study was conducted in 39 patients with advanced colorectal cancer who were treated with capecitabine-based two-drug combination chemotherapy initially, including 32 patients who took capecitabine plus oxaliplatin （CapeOx） regimen and 7 patients treated with capecitabine in combination with irinotecan （Capiri）. Results The incidence of hand-foot syndrome （HFS） in the 39 patients for grade 1, 2, 3 was 35.9%, 17.9%, and 7.7% respectively. The overall response rate （RR） in patients occurring HFS was 45.8%, while it was 13.3% in those without HFS, P= 0.024; disease control rate （DCR） was 75% vs 40% in patients with or without HFS, there was a trend of improving DCR in patients with HFS, P= 0.065. Conclusion Hand-foot syndrome is the main dose-limiting toxicity of capecitabine as a therapy to advanced colorectal cancer. The occurrence of HFS induced by capecitabine indicates a higher response rate, but it needs further validation studies.