奥沙利铂联合卡培他滨治疗晚期肝细胞癌的疗效及安全性

Curative effect and security of oxaliplatin combination with capecitabine on advanced primary hepatocarcinoma

目的探讨奥沙利铂联合卡培他滨治疗无法手术切除的晚期肝细胞癌患者的疗效及安全性。方法经病理组织学检查确诊的局部晚期、无法手术或已有远处转移的晚期肝细胞癌患者18例,给予奥沙利铂和卡培他滨进行全身化学治疗,奥沙利铂130 mg.m-2,静脉滴注,第1天;卡培他滨每日1 800 mg.m-2,分2次口服,第1～14天,21 d为1个周期;直至疾病进展或最多不超过6个周期停止用药。每2个周期评价客观疗效,观察至病情进展时间(TTP)和生存期(OS),并动态监测血清甲胎蛋白(AFP)的变化,评定药物的毒副作用。结果 18例患者全部可以评估疗效,获得完全缓解1例,部分缓解3例,稳定6例,进展8例,客观缓解率为22.2%(4/18),疾病控制率为55.6%(10/18);中位TTP为3.1个月,中位OS为12.6个月,AFP反应率为53.3%。常见的毒副作用为中性粒细胞减少、轻度的周围神经毒性和手足综合征。结论以奥沙利铂联合卡培他滨治疗晚期肝细胞癌患者具有良好的客观疗效和一定的生存获益,不良反应较轻,易于耐受。

Objective To observe the efficacy and safety of oxaliplatin（OXA） combination with capecitabine on unresectable advanced primary hepatocarcinoma（HCC）.Methods Eighteen patients with unresectable HCC or with metastasis were given chemotherapy with OXA 130 mg·m-2 on the first day by intravenous drip and capecitabine 1 800 mg·m-2 orally from the first day to the fourteenth day,two times per day,twenty-one days as a cycle.The patients were discontinued medication when the disease progressed or the patients finished chemotherapy for the six cycles.The objective curative effect was evaluated every two cycles and the time to progression（TTP） and overall survival（OS） were observed.Serum AFP level was also monitored according the schedule.Toxicities were also evaluated.Results Eighteen patients all were evaluable for efficacy.One patient obtained complete response（CR）,three patients were partial response（PR）,six patients were stable disease（SD）,and eight patients were disease progression（PD）.The objective remission rate was 22.2%（4/18） and disease control rate was 55.6%（10/18）.The median TTP and median OS were 3.1 months and 12.6 months,respectively.AFP response rate was 53.3%.The main observed adverse effects were granulocytopenia,mild peripheral neurotoxicity and hand-foot syndrome.Conclusion Systemic chemotherapy with OXA and capecitabine for advanced HCC shows satisfactory objective response and possible survival benefit with mild adverse effects.