厄洛替尼联合卡培他滨一线治疗胰腺癌的疗效观察

Effect of erlotinib combined with capecitabine as first-line treatment for pancreatic cancer

目的观察厄洛替尼联合卡培他滨方案一线治疗局部晚期或伴转移的胰腺癌的疗效和安全性。方法将40例未接受过全身化疗的局部晚期或伴转移的胰腺癌患者分为观察组和对照组。观察组患者接受至少2个周期厄洛替尼联合卡培他滨方案（卡培他滨1000mg／m^口服，2次／d，第1-14天。厄洛替尼150mg／d口服，连续21d）的化疗；对照组患者接受吉西他滨单药（1000mg／m^，静脉注射，1次／周，连续7周，休1周）治疗。结果观察组20例患者中2例（10％）达到部分缓解，10例（50％）病情稳定，8例（40％）病情进展，客观缓解率为10％，疾病控制率为60％，中位无进展生存期3．1个月，中位生存期6．4个月，均优于对照组的1例、8例、11例、5％、45％、2．2个月、5．8个月，其中客观缓解率、中位无进展生存期两组差异有统计学意义（P〈0．05或〈0．01）。主要不良反应为非血液学毒性，多为I～Ⅱ级的腹泻和皮疹等，无药物毒性相关性死亡。结论厄洛替尼联合卡培他滨一线治疗局部晚期或伴转移的胰腺癌疗效优于吉西他滨单药治疗组，患者总体临床耐受性良好。

Objective To evaluate the clinical efficacy and safety of erlotinib combined with capecitabine as fist-line treatment for pancreatic carcinoma. Methods Forty pancreatic carcinoma patients who had locally advanced or metastatic disease without systematic chemotherapy were divided into control group （ n = 20） and treatment group （ n = 20 ）. The treatment group received erlotinib plus capecitabine for at least two cycles （oral capecitabine 1 000 mg/m^2, bid, from 1st - 14th days, oral erlotinib 150 mg, qd, for 3 weeks） , while the control group was given gemcitabine alone（ 1 000 mg/m^2, iv, once a week, for 7 weeks）. Results In the treatment group, 2 patients （10%） achieved partial remission, 10 patients （50%） were stable, 8 patients （40%）were progressed, and the disease control rate was 60%. The median progression-free survival was 3.1 months and median overall survival was 6.4 months, which were better than the corresponding values in control group （1, 8, 11 cases, 45% , 2.2 months, 5.8 months）. Major adverse effects were non- hematological toxicities, mainly grade I and II skin rash and diarrhea, without chemotherapy related death. Conclusions The efficacy of erlotinib combined with capecitabine as first-line treatment for patients with advanced pancreatic cancer is better than gemcitabine alone, and the patients are generally well tolerated.