替吉奥胶囊在晚期大肠癌患者维持治疗中的临床观察
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摘要
目的:观察替吉奥在晚期大肠癌(结直肠癌)患者维持治疗的疗效和不良反应。方法:38例确诊为晚期大肠癌的患者,经过氟尿嘧啶类组成的联合化疗方案化疗4~6周期,化疗后部分缓解(partial response,PR)或疾病稳定(stable disease,SD)的患者,被分为治疗组和观察组。治疗组采用替吉奥单药口服维持治疗,连用2周,停药1周,3周为一个周期。观察组不予任何治疗。每2周期后行影像学检查评价疗效、不良反应及随访情况。结果:治疗组总有效率为45.5%,临床受益率为81.8%,中位无疾病进展时间为5.7个月,中位总生存期为10.9个月;观察组总有效率为31.3%,临床受益率为68.8%,中位无疾病进展时间为3.1个月,中位总生存期为6.7个月;两组近期疗效、中位无疾病进展时间及中位生存期比较差异有统计学意义(P<0.05)。毒副反应主要为Ⅰ~Ⅲ度骨髓抑制、消化道反应、肝功能损伤及手足综合症。结论:替吉奥在晚期大肠癌患者维持治疗中效果肯定、生存质量高、毒副作用小。
Objective: To evaluate the clinical efficacy, the clinical benefit response and adverse reaction of S-1 in the maintenance therapy of patients with advanced colorectal cancer(colon cancer and rectal cancer). Methods: Thirtyeight patients with advanced colorectal cancer who underwent combined chemotherapy of fluorouracil in 4~6 cycles. The partial response(PR) or stable disease(SD) patients were divided into S-1 group and observation group after chemotherapy. For the S-1 group, 3 weeks constituted a cycle. Among the cycle, taking 2 weeks for S-1, 1 week of stopping medication. In the observation group, no treatment was performed. After two consecutive treatment circles, the clinical efficacy, adverse effects and follow-up condition were evaluated. Results: The total response rate of S-1 group was 45.5% and 31.3% of the observation group and the progress free sur v ival(PFS) were 5.7 and 3.1 months respectively. The clinical benefit response of S-1 group was 81.8% and 68.8% of the observation group and the MST were 10.9 and 6.7 months respectively. There was significant difference between the two groups(P<0.05). The major adverse events were myelosuppression ranging from grade I to III, disgusting damage of liver function and hand-foot syndrome. Conclusion: The S-1 shows positive effect for patients with advanced colorectal cancer in the maintenance therapy. It can achieve a better quality of life and small side effects for the patients.
Objective: To evaluate the clinical efficacy, the clinical benefit response and adverse reaction of S-1 in the maintenance therapy of patients with advanced colorectal cancer(colon cancer and rectal cancer). Methods: Thirtyeight patients with advanced colorectal cancer who underwent combined chemotherapy of fluorouracil in 4~6 cycles. The partial response(PR) or stable disease(SD) patients were divided into S-1 group and observation group after chemotherapy. For the S-1 group, 3 weeks constituted a cycle. Among the cycle, taking 2 weeks for S-1, 1 week of stopping medication. In the observation group, no treatment was performed. After two consecutive treatment circles, the clinical efficacy, adverse effects and follow-up condition were evaluated. Results: The total response rate of S-1 group was 45.5% and 31.3% of the observation group and the progress free sur v ival(PFS) were 5.7 and 3.1 months respectively. The clinical benefit response of S-1 group was 81.8% and 68.8% of the observation group and the MST were 10.9 and 6.7 months respectively. There was significant difference between the two groups(P<0.05). The major adverse events were myelosuppression ranging from grade I to III, disgusting damage of liver function and hand-foot syndrome. Conclusion: The S-1 shows positive effect for patients with advanced colorectal cancer in the maintenance therapy. It can achieve a better quality of life and small side effects for the patients.
引文
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8 .蒋丽媛,赵彩霞,冯艳光,等.吉西他滨联合替吉奥胶囊治疗晚期食管癌患者的临床观察[J].实用肿瘤学杂志,2014,28(1):30-33.JIANG Liyuan,ZHAO Caix ia,FENG Yanguang,et al.Clinical obser vation of gemcitabine combined with S-1 on patients with advanced esophageal cancer[J].Practical Oncology Journal,2014,28(1):30-33.
9 .葛伯建,高湘湘,顾寄树,等.替吉奥胶囊联合多西他赛治疗晚期食管癌临床疗效观察[J].实用临床医药杂志,2011,15(17):102-104.GE Bojian,GAO Xiangxiang,GU Jishu,et al.Clinical observation of S-1 capsule combined with Docetaxel on patients with advanced esophageal cancer[J].Journal of Clinical Medicine in Practice,2011,15(17):102-104.
2 .Cui Y,Li Q,Yu Y,et al.Combination of low-dose docetaxel and standard-dose S-1 for the treatment of advanced gastric cancer:efficacy,toxicity,and potential predictive factor[J].Cancer Chemother Pharmacol,2013,71(1):145-152.
3 .Zhou Y,Huang J,Yang L,et al.A safety analysis in patients treated with oxaliplatin plus S-1 as adjuvant therapy for gastric cancer[J].Zhonghua Zhong Liu Za Zhi,2012,34(11):860-864.
4 .Liu HY,Ding L,Yu Y,et al.Pharmacokinetics of S-1 capsule in patients with advanced gastric cancer[J].Yao Xue Xue Bao,2012,47(10):1363-1369.
5 .Egawa T,Kemmochi T,Irino T,et al.Adjuvant chemotherapy with S-1plus docetaxel for highly advanced gastric cancer patients[J].Gan To Kagaku Ryoho,2012,39(12):2310-2312.
6 .方伟达,陈昌南,张呈,等.低剂量替吉奥口服治疗放弃静脉化疗的晚期结直肠癌[J].现代肿瘤医学,2011,19(9):1823-1825.FANG Weida,CHEN Changnan,ZHANG Cheng,et al.Effect oforal low-dose gimeracil and oteracil porassium capsules on advanced colorectal cancer giving up intravenous chemotherapy[J].Journal of Modern Oncology,2011,19(9):1823-1825.
7 .Xu RH,Qiu MZ.Progression in palliative chemotherapy for advanced colorectal cancer[J].Ai Zheng,2008,27(6):661-666.
8 .蒋丽媛,赵彩霞,冯艳光,等.吉西他滨联合替吉奥胶囊治疗晚期食管癌患者的临床观察[J].实用肿瘤学杂志,2014,28(1):30-33.JIANG Liyuan,ZHAO Caix ia,FENG Yanguang,et al.Clinical obser vation of gemcitabine combined with S-1 on patients with advanced esophageal cancer[J].Practical Oncology Journal,2014,28(1):30-33.
9 .葛伯建,高湘湘,顾寄树,等.替吉奥胶囊联合多西他赛治疗晚期食管癌临床疗效观察[J].实用临床医药杂志,2011,15(17):102-104.GE Bojian,GAO Xiangxiang,GU Jishu,et al.Clinical observation of S-1 capsule combined with Docetaxel on patients with advanced esophageal cancer[J].Journal of Clinical Medicine in Practice,2011,15(17):102-104.