氟尿嘧啶类联合奥沙利铂方案治疗晚期转移性小肠癌的回顾性多中心研究

A Retrospective Study on Oxaliplatin Combined with Fluoropyrimidines for Advanced Small Bowel Adenocarcinoma

    摘要
  • 摘要:
      目的  小肠癌是一种少见的消化道肿瘤, 多数患者初诊时已无法手术切除或出现远处转移, 因此化疗在小肠癌治疗中占有重要地位。本研究旨在评价FOLFOX和XELOX方案治疗晚期中国小肠癌患者的疗效及安全性。
      方法  对2004年1月~2010年1月期间, 在中山大学肿瘤医院等3个中心所有接受过FOLFOX或XELOX方案化疗的34例晚期小肠癌患者进行了回顾性分析。利用SPSS13.0统计软件对方案的有效率(RR), 无进展生存时间(PFS), 总生存时间(OS)以及化疗相关的不良反应进行分析。
      结果  共纳入病例34例, 其中28例接受了FOLFOX治疗, 6例接受了XELOX方案治疗。客观有效率及疾病控制率分别为32.3%和61.7%。中位PFS和OS分别为6.3和14.2个月。化疗相关不良反应可耐受, 3~4级不良反应发生率较少, 其中1~2级纳差(58.8%)、恶心(47.1%)、外周神经毒性(41.2%)是最常见的反应。
      结论  本研究在国内首次报道了奥沙利铂联合氟尿嘧啶类方案治疗晚期小肠癌疗效, 结果显示FOLFOX或XELOX方案治疗晚期小肠癌安全有效, 该方案仍值得进一步研究。

     

    Abstract:
      Objective  This study evaluates the efficacy and toxicity of oxaliplatin regimen combined with fluoropyrimidines in Chinese patients with advanced small bowel adenocarcinoma (SBA).
      Methods  Advanced SBA patients who received FOLFOX/CAPOX as the first-line chemotherapy between April 2004 and October 2010 from three hospitals were retrospectively analyzed. The response rate, progression-free survival, overall survival, and chemotherapy-associated toxicity were evaluated using SPSS 13.0.
      Results  A total of 34 patients were enrolled in the study, 28 of which received FOLFOX6 and 6 received XELOX. The objective response and disease control rates were 32.3% and 61.7%, respectively. The median progression-free survival and overall survival were 6.3 and 14.2 months, respectively. The toxicity was tolerable, and a toxicity grade of 3-4 was rare. In addition, anorexia (58.8%), nausea (47.1%), and peripheral neuropathy (32.4%) were the most common toxic reactions, with a toxicity grade of 1-2.
      Conclusions  This study was the first to report the efficacy of oxaliplatin combined with fluoropyrimidines as the first-line chemotherapy for advanced SBA in China. FOLFOX/CAPOX is proven effective and safe for advanced SBA, and is worthy of further study.

     

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