卡培他滨和奥沙利铂治疗晚期小肠和壶腹癌的研究

The Study of Capecitabine and Oxaliplatin in the Treatment of Advanced Small Bowel and Ampullary Carcinoma

目的:评估卡培他滨联合奥沙利铂(CAPOX)治疗晚期小肠或壶腹源性腺癌的疗效。方法:选取佳木斯市肿瘤医院30名符合条件的患者作为研究对象,以21天的周期在第1天静脉注射奥沙利铂130 mg/m2,第1天至第14天口服卡培他滨750 mg/m2每天2次,主要终点是根据实体瘤疗效评价标准评估的总有效率。结果:总有效率为50%;3例转移性疾病患者获得完全缓解。中位进展时间(TTP)为11.3个月,中位总生存期(OS)为20.4个月。仅转移性疾病患者(25例)的亚组分析显示,中位TTP为9.4个月,中位OS为15.5个月。最常见的3级或4级毒性包括疲劳(30%)、周围神经病变(10%)、呕吐(10%)、腹泻(10%)和中性粒细胞减少(10%)。结论:CAPOX耐受性好,有效率高,总生存期长,应该被认为是晚期小肠和壶腹癌的一种新的标准治疗方案。

Objective: To evaluate the efficacy of capecitabine combined with oxaliplatin(CAPOX) in the treatment of advanced small bowel or ampullary adenocarcinoma. Methods: Thirty eligible patients from Jiamusi Cancer Hospital were selected as the research subjects. Oxaliplatin was injected intravenously at 130 mg/m2 on the first day in a 21-day cycle, and capecitabine was taken orally at 750 mg/m2 from day 1 to day 14 twice a day, the primary end point is the total effective rate evaluated according to the evaluation criteria for the efficacy of solid tumors. Results: The total effective rate was 50 %;3 patients with metastatic disease achieved complete remission. The median time to progression(TTP) was 11.3 months, and the median overall survival(OS) was 20.4 months. Only a subgroup analysis of patients with metastatic disease(25 cases) showed that the median TTP was 9.4 months and the median OS was 15.5 months. The most common grade 3 or 4 toxicities include fatigue(30 %), peripheral neuropathy(10 %), vomiting(10 %), diarrhea(10 %), and neutropenia(10 %). Conclusion: CAPOX is well tolerated, effective, and has a long overall survival. It should be considered as a new standard treatment for advanced small bowel and ampulla carcinoma.