转移性结直肠癌一线化疗控制后卡培他滨维持的临床疗效评价
摘要
目的评价卡培他滨维持治疗晚期转移性结直肠癌患者的可行性及安全性。方法采用非完全回顾性研究方法,共收集分析67例经过一线化疗获益的晚期转移性结直肠癌患者的临床资料。32例给予卡培他滨单药维持(维持组),另外35例同期仅进行随访观察(对照组)。比较两组中位无进展生存期(PFS)及临床疗效(总控制率),比较两组在维持治疗期间的化疗不良反应率;比较维持组在维持治疗期间与一线化疗期间的化疗不良反应率。结果 Kaplan-Meier曲线显示维持组中位PFS(12.03±2.78)个月,对照组(8.10±1.4)个月,两组差异有统计学意义(P=0.001)。维持组的临床疗效(总控制率)优于对照组(P=0.011)。维持组与对照组在维持治疗期间的化疗不良反应率相似(P>0.05)。维持组在维持治疗期间比一线化疗期间的化疗不良反应率低,更能耐受(P<0.05)。结论晚期转移性结直肠癌一线化疗获益后给予单药卡培他滨维治疗能够延长患者中位PFS,提高总体生存率,且患者能够很好地耐受。
引文
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[3]HUANG H,JIANG Z,WANG T,et al.Single-agent capecitabine maintenance therapy after response to capecitabinebased combination chemotherapy in patients with metastatic breast cancer[J].Anticancer Drugs,2012,23:718-723.
[4]KARAYAMA M,INUI N,KUROISHI S,et al.Maintenance therapy with pemetrexed versus docetaxel after induction therapy with carboplation and pemetrexed in chemotherapy-nave patients with advanced non-squamous non-small-cell lung cancer:a randomized,phaseⅡstudy[J].Cancer Chemother Pharmacol,2013,72(2):445-452.
[5]YOUNG J,BADGERYOPARKER T,DOBBINS T,et al.Comparison of ECOG/WHO performance status and ASAscore as a measure of functional status[J].J Pain Symptom Manage,2015,49(2):258-264.
[6]丁婕,戴旭,孟宪运,等.实体瘤疗效评价标准的研究进展[J].中国肿瘤临床与康复,2015(9):1150-1152.
[7]LOUVET C,DE G A,TOURNIGAND C,et al.Correlation between progression free survival and response rate in patients with metastatic colorectal carcinoma[J].Cancer,2015,91(11):2033-2038.
[8]LIU Y J,ZHU G P,GUAN X Y.Comparison of the NCICTCAE version 4.0and version 3.0in assessing chemoradiation-induced oral mucositis for locally advanced nasopharyngeal carcinoma[J].Oral Oncol,2012,48(6):554-559.
[9]VAN CUTSEM E,RIVERA F,BERRY S,et al.Safety and efficacy of first-line bevacizumab with FOLFOX,XE-LOX,FOLFIRI and fuoropyrimidines in metastatic colorectal cancer:the BEAT study[J].Ann Oncol,2009,20(11):1842-1847.
[10]AYEZ N,BURGER J W,VANDER POOL A E,et al.Long-term results of the“liver first”approach in patients with locally advanced rectal cancer and synchronous liver metastases[J].Dis Colon Rectum,2013,56(3):281-287.
[11]TOURNIGAND C,CERVANTES A,FIGER A,et al.OP-TIMOX1:a randomized study of FOLFOX4or FOLFOX7with oxaliplatin in a stop-and-Go fashion in advanced colorectal cancer-a GERCOR study[J].Clin Oncol,2006,24(3):394-400.
[12]CHIBAUDEL B,MAINDRAULT-GOEBEL F,LLEDOG,et al.Final results of OPTIMOX2,a large randomized phaseⅡstudy of maintenance therapy or chemotherapyfree intervals(CFI)after FOLFOX in patients with metastatic colorectal cancer(MRC):A GERCOR study[J].Clin Oncol,2007,25(18):4013-4014.
[13]CASSIDY J,CLARKE S,DIAZ-RUBIO E,et al.XELOXvs FOLFOX4as first-line therapy for metastatic colorectal cancer:NO16966updated results[J].Br J Cancer,2011,105(1):58-64.
[14]DIAZ-RUBIO E,GOMEZ-ESPANA A,MASSUTI B,et al.First-line XELOX plus bevacizumab followed by XE-LOX plus bevacizumab or single-agent bevacizumab as maintenance therapy in patients with metastatic colorectal cancer:the phaseⅢMACRO TTD study[J].Oncologist,2012,17(1):15-25.
[15]GOEY K K H,ELIAS S G,VAN TINTEREN H,et al.Maintenance treatment with capecitabine and bevacizumab versus observation in metastatic colorectal cancer:updated results and molecular subgroup analyses of the phase 3 CAIRO3study[J].Ann Oncol,2013,28(9):2128-2134.
[16]MIWA M,URA M,NISHIDA M,et al.Design of a novel oral fluoropyrimidine carbamate,capecitabine,which generates 5-fluorouracil selectively in tumours by enzymes concentrated in human liver and cancer tissue[J].Eur JCancer,1998,34(8):1274-1281.
[17]WADDELL T,GOLLINS S,SOE W,et al.Phase II study of short-course capecitabine plus oxaliplatin(XELOX)followed by maintenance capecitabine in advanced colorectal cancer:XelQuali study[J].Cancer Chemother Pharmacol,2011,67(5):1111-1117.
[18]LUO H Y,LI Y H,WANG W,et al.Single-agent capecitabine as maintenance therapy after induction of XELOX(or FOLFOX)in first-line treatment of metastatic colorectal cancer:randomized clinical trial of efficacy and safety[J].Ann Oncol,2016,27(6):1074-1081.