卡培他滨单药维持治疗晚期胃癌疗效分析

Efficacy of capecitabine monotherapy maintenance treatment for patients with advanced gastric cancer

  • 摘要: 目的 评价卡培他滨单药维持治疗晚期胃癌的效果和不良反应。 方法 回顾性分析我院2008年1月- 2014年6月的82例一线给予化疗的晚期胃癌患者,均经全身化疗后完全缓解(CR)、部分缓解(PR)或稳定(SD)。其中41例在化疗后应用卡培他滨单药维持治疗,给予卡培他滨剂量为1 250 mg/m2,2次/d,连用14 d,每3周为1个周期,用药至疾病进展或未进展的末次随访时间,所有患者至少接受2周期治疗。化疗后未进行维持治疗的41例为对照组。观察两组中位无疾病进展时间和1年、2年生存率,以及卡培他滨的不良反应。 结果 维持治疗组与对照组中位无进展生存期分别为7.90个月、5.10个月(P< 0.05)。1年生存率分别为48.8%、26.8%(P< 0.05);2年生存率分别为9.8%、4.9%(P> 0.05)。不良反应主要为手足综合征20例(48.8%)、骨髓抑制16例(39.0%)和胃肠道反应15例(36.6%,以1 ~ 2度为主),大多可以耐受。 结论 卡培他滨单药维持治疗一线化疗后的晚期胃癌可延长疾病未进展时间和提高1年生存率,依从性好,不良反应可耐受。

     

    Abstract: Objective To estimate the efficacy and toxic reaction of capecitabine monotherapy for patients with advanced gastric cancer. Methods Retrospective analysis was performed in 82 patients with advanced gastric cancer treated in our hospital form January 2008 to June 2014, and all patients had achieved complete response (CR), partial remission (PR) or stable disease (SD)after the systemic chemotherapy. Of the 82 cases, 41 patients were given capecitabine maintenance treatment with a dose of capecitabine accounting for 1 250 mg/m2, 2 times/d, continually for 14 days, 3 weeks for a period. Treatment was followed during disease progression or progression of last follow-up. All patients had achieved at least 2 cycles of treatment. Another 41 patients without maintenance treatment were served as control group. The median progression-free survival and 1- and 2-year survival rates, and the capecitabine adverse reactions were observed. Results The median progression-free survival time was 7.9 months for the maintenance treatment group and 5.1 months for control group (P< 0.05), the 1-year survival rate was 48.8% (20/41) and 26.8% (11/41), respectively (P< 0.05), and the 2-year survival rate was 9.8% (4/41) and 4.9% (2/41), respectively (P> 0.05). The complications included hand-foot syndrome in 20 cases (48.8%), arrest of bone marrow in 16 cases (39.0%), and gastrointestinal reaction in 15 cases (36.6%), the reaction that was mostly ofⅠorⅡ degree could be tolerated well. Conclusion Capecitabine monotherapy maintenance treatment can prolong the median progression-free survival rate and improve the 1-year survival rate, in addition, the treatment compliance is good and the gastrointestinal reaction is well tolerated in patients.

     

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