羟基喜树碱、奥沙利铂和卡培他滨联合治疗晚期胃癌的临床观察

摘要

探讨羟基喜树碱、奥沙利铂和卡培他滨三药联合(HOX方案)治疗晚期胃癌的疗效和毒副反应.方法 2007年10月至2009年10月我科对48例晚期胃癌患者采用HOX方案治疗,具体为:羟基喜树碱6mg/m2静滴,d1～d5；奥沙利铂100mg/m2静滴,d1；卡培他滨1250mg/m2分2次口服,d1～d14；21天为1周期.每2个周期按RECICT 1.0标准评价疗效,每周期按CTC AE 3.0标准评价毒副反应.结果 全组48例均可评价疗效和毒副反应.其中,获CR 5例,PR 26例,SD 14例,总有效率为64.6％ (31/48),疾病控制率93.8％ (45/48)；1年生存率为48％,中位生存期8.5个月.主要毒副反应为骨髓抑制、手足综合征以及周围神经毒性,大多为1～2级,未发生治疗相关性死亡.结论 HOX方案治疗晚期胃癌的疗效较好,不良反应轻,值得进一步临床观察应用.%Objective To explore the efficacy and toxicity of hydroxycamptothecin ( HCPT) combined with oxaliplatin and capecitabine( HOX regimen) in treatment of patients with advanced gastric cancer. Methods Forty eight cases with advanced gastric cancer enrolled from October 2007 to October 2009 were administrated with HOX regimen, including HCPT 6mg/m2 iv d1 -d3 , oxaliplatin 100mg/m2 iv d, and capecitabine 1250mg/m2 orally bid d1-d14. Twenty-one days was a cycle. The efficacy was evaluated every 2 cycles according to RECICT 1. 0 cretiria and toxicity was evaluated every 1 cycle according to CTC AE 3. 0 cretiria. Results All patients were eligible for efficacy and toxicity. The overall response rate was 64. 6% (31/48), including CR 5 cases( 10% ) and PR 26 cases(54. 5% ). Disease controle rate was 93. 8% , including SD 14 cases(29.2% ). The major toxicity was mild to moderate, including bone marrow suppresion, hand-foot syndrom and peripheral nerves toxicity. No treatment-related death occurred. Conclusion HOX regimen is effective and tolerable for patients with advanced gastric cancer and worthy of further clinical observation.