转移性结直肠癌化疗控制后卡培他滨维持治疗分析

Study of capecitabine maintenance therapy effectiveness on metastatic colorectal cancer patients with disease optimally controlled after the chemotherapy

目的:探讨转移性结直肠癌经含氟尿嘧啶类药物联合化疗得到控制后卡培他滨维持治疗的可行性。方法:35例转移性结直肠癌患者采用含氟尿嘧啶类的联合化疗达到肿瘤最大缩小率后,单药卡培他滨维持治疗,分析PFS、骨髓抑制、肝肾功能损害、手足综合征等不良反应。结果:接受卡培他滨维持治疗全组35例患者中位PFS:12.2个月,一线化疗后中位PFS:12.4个月;二线化疗后中位PFS11.6个月;含奥沙利铂患者中位PFS12.3个月,含伊利替康患者PFS11.9个月。35例患者前期含氟尿嘧啶类药物联合化疗Ⅲ/Ⅳ度不良反应较多见。结论:转移性结直肠癌在含氟尿嘧啶类联合方案化疗后卡培他滨单药维持治疗可获得较长的PFS,提示对晚期结直肠癌可能延长PFS并转化为生存获益,患者耐受性良好,值得进一步研究明确维持治疗的临床价值。

Objective To explore the Metastatic Colorectal Cancer patients＇ feasibility of continual Xeloda （Capecitabine） Maintenance Therapy after being treated with proper chemotherapies. Method 35 Metastatic Colorectal Cancer patients, who received proper chemotherapy treatments with stable treatment efficacy or complete remission, were selected in this research. When the disease optimal control was achieved, were treated with a maintenance therapy with only Capecitahine. Such statistical analysis method was used to analyze PFS and Myelosuppression, liver and kidney injury, hand-foot skin reaction and other Adverse Drug Reactions ADR. Results The median progress-free survival （PFS） time for all patients receiving Xeloda maintenance therapy was 12.2 months, the median PFS time for first-line was 12.4 months, the median PFS time for second-line patients was 11.6 months. Containing oxaliplatin chemotherapy patients PFS12.3 months, with irinotecan chemotherapy patients PFS11.9 months. Containing fluorouracil chemotherapy patients suffered Ⅲ/Ⅳ adverse reaction were more to view. Conclusion Metastatic Colorectal Cancer patients with fluorouracil based combination chemotherapy had achieved longer PFS after being given Capecitabine Maintenance Therapy. Our research showed that maintenance therapy could bring more survival benefits, better tolerance and less haematological and non haematological toxicity occurrence. Therefore, it is worthwhile to further evaluate the benefits of maintenance therapy.