吉西他滨治疗晚期恶性实体瘤的疗效观察

The Efficacy and Toxicity of Gemcitabine in the Treatment of Advanced Malignant Tumors

目的 :观察以吉西他滨 (健择 ,gemcitabine)为主的联合化疗方案对晚期实体瘤的近期疗效、毒副反应。方法 :30例晚期恶性实体瘤患者中 ,初治 2 2例 ,复治 8例。肺癌、乳腺癌用健择加顺铂方案 ;胰腺癌用健择加LF方案 ;肝癌肺转移用健择加羟基喜树碱。每例化疗持续 2周期以上 ,共 68个周期治疗。结果 :30例化疗患者有效率 (RR)达 4 6.7% ,稳定 (SD)者占 4 6.7% ,进展 (PD) 6.7%。毒副反应Ⅲ～Ⅳ度白细胞减少者为 2 0 .6% ,Ⅲ～Ⅳ度血小板减少者为 2 9.4 % ,Ⅲ～Ⅳ度血红蛋白降低者为8 8%。因毒副反应而周期内延期 14次 (2 0 .6% ) ,但整个化疗方案仍得以顺利实施。其他毒副反应不影响化疗方案的进行。结论 :健择是治疗晚期恶性实体瘤较为安全可靠的抗癌药物之一 ,毒副反应轻微 ,易耐受 ,疗效满意 。

Objiective To observe the efficacy and toxicity of gemcitabine in the treatment of advanced malignant tumors.Methods Of 30 cases,including untreated tumors 22 cases,recurrent tumors 8 cases.NSCLC and breast cancer were treated by gemcitabine plus cisplatin;Gemcitabine in combination with LF was applied to treat pancreatic cancer;Advanced hepatic cancer was treated by gemcitabine plus HCPT.Results The response rate(CR+PR) was 46.7%.The main toxicity was hematological :Cycles of hemoglobin,neutropenia and platelete of WHO grade Ⅲ-Ⅳ were 8.8%,20.6%,29.4% respectively.The non hematological toxicity was mild and tolerable.Of 68 cycles,only 14 cycles (20.6%) gemcitabine injection were prolonged due to toxicity.Conclusion The regimen of gemcitabine in combination with cisplation,5 FU,or CF is effective,safe and well tolerance in the treatment of NSCLC,hepatic cancer,et al.It could be regarded as a recommended standard regimen and is worth to be further studied.