潘战和, 苏安, 王馨, 蔡清清, 高岩, 卜庆, 吕霞. 草酸铂联合卡培他滨一线化疗后卡培他滨维持治疗晚期胃癌[J]. 中国肿瘤临床, 2012, 39(20): 1552-1555. DOI: 10.3969/j.issn.1000-8179.2012.20.024
引用本文: 潘战和, 苏安, 王馨, 蔡清清, 高岩, 卜庆, 吕霞. 草酸铂联合卡培他滨一线化疗后卡培他滨维持治疗晚期胃癌[J]. 中国肿瘤临床, 2012, 39(20): 1552-1555. DOI: 10.3969/j.issn.1000-8179.2012.20.024
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Zhanhe PAN, An SU, Xin WANG, Xin WANG, Qingqing CAI, Yan GAO, Qing BU. Clinical Observation of Oxaliplatin plus Capecitabine with Subsequent Capecitabine Maintenance Chemotherapy for Patients with Advanced Gastric Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(20): 1552-1555. DOI: 10.3969/j.issn.1000-8179.2012.20.024
Citation: Zhanhe PAN, An SU, Xin WANG, Xin WANG, Qingqing CAI, Yan GAO, Qing BU. Clinical Observation of Oxaliplatin plus Capecitabine with Subsequent Capecitabine Maintenance Chemotherapy for Patients with Advanced Gastric Cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2012, 39(20): 1552-1555. DOI: 10.3969/j.issn.1000-8179.2012.20.024
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草酸铂联合卡培他滨一线化疗后卡培他滨维持治疗晚期胃癌

Clinical Observation of Oxaliplatin plus Capecitabine with Subsequent Capecitabine Maintenance Chemotherapy for Patients with Advanced Gastric Cancer

    摘要
  • 摘要:
      目的  探讨晚期胃癌草酸铂/卡培他滨一线化疗后继续卡培他滨维持化疗的疗效与不良反应。
      方法  62例初治晚期胃癌患者, 采用草酸铂/卡培他滨化疗; 最多6个周期化疗后疗效评价无疾病进展的患者中, 32例进行卡培他滨维持化疗（2 000 mg/m2/d, d1~14, 21 d重复）, 维持化疗持续到疾病进展或出现不能耐受毒性为止。
      结果  62例患者共接受315个周期初始化疗, 均可评价疗效, 总有效率51.6%。初始化疗后49例疗效评价无疾病进展, 其中17例随访观察, 32例继续卡培他滨维持化疗。维持化疗组总有效率和疾病控制率分别为28.1%、78.1%, 均好于随访观察组（总有效率和疾病控制率分别为0、47.1%, P < 0.05）。维持化疗组中位疾病进展时间7.9个月, 较对照观察组5.7个月延长（P < 0.05）, 中位生存时间分别为14.9个月和13.4个月（P>0.05）。主要不良反应有恶心、呕吐、腹泻、骨髓抑制、手足综合征等, 经对症治疗后均好转, 无治疗相关死亡。
      结论  草酸铂/卡培他滨一线化疗后卡培他滨维持治疗晚期胃癌可增加有效率、延长疾病进展时间, 并有延长总生存期的趋势, 值得进一步研究。

     

    Abstract:
      Objective  This study aimed to investigate the curative effect and safety of capecitabine maintenance chemotherapy after the first-line oxaliplatin/capecitabine chemotherapy for patients with advanced gastric cancer (AGC).
      Methods  A total of 62 chemotherapy-naïve AGC patients were enrolled into this study. They received 2 h of intravenous infusion of oxapliplatin (130 mg/m2) on day 1, and an oral administration of capecitabine (2 000 mg/m2) given in two daily doses on days 1–14 (XELOX regimen). The therapeutic regimen was repeated every 21 days. A maximum six-cycle dosage was given. A total of 49 patients who responded to the therapy were assigned to either the group with capecitabine maintenance chemotherapy (G1; 2 000 mg/m2 given in two daily doses on days 1–14) or with clinical observation (G2). Among the 49 patients, 32 were in G1 and 17 patients were in G2. The maintenance therapy continued until disease progression or intolerable toxicity.
      Results  A total of 315 cycles of the chemotherapy were completed in 62 AGC patients, with a median of five cycles per patient. All patients were evaluated for the therapeutic efficacy. The response rate (RR) was 51.6% in the patients. Among the 49 patients who responded to the XELOX regimen, 32 received capecitabine maintenance chemotherapy. The RR and disease control rate were 28.1% and 78.1% in G1, and 0% and 47.1% in G2, respectively (P < 0.05). At a median follow-up of 17 months, the median time to progression was longer in G1 (7.9 months) than in G2 (5.7 months) (P < 0.05). The median overall survival time was 14.9 and 13.4 months in G1 and G2, respectively (P>0.05). The most common adverse events included nausea/vomiting, diarrhea, myelosuppression, and hand-foot syndrome.
      Conclusion  Capecitabine maintenance chemotherapy can benefit the RR and median time to progression, but not the overall survival time in AGC patients who respond to oxaliplatin/capecitabine induction chemotherapy. However, further evaluation of the efficacy of capecitabine maintenance chemotherapy is needed

     

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