摘要
目的:评价卡培他滨(capecitabine)联合依立替康(irinotecan)或重组人血管内皮抑制素(rh-endostatin,商品名为恩度)治疗奥沙利铂(oxaliplatin)耐药晚期结直肠癌的疗效及安全性。方法:回顾性分析45例奥沙利铂治疗无效的晚期结直肠癌患者的临床资料,采用卡培他滨联合依立替康治疗25例、卡培他滨联合恩度治疗20例。结果:随访3～21个月,依立替康组有效率(RR)为32.0%,临床受益率(CBR)为72.0%,肿瘤进展时间(TTP)为6.2(95%可信区间:3.125～8.905)个月;恩度组RR为55.0%,CBR为90.0%,TTP为10.6(95%可信区间:7.876～12.962)个月;两组比较各项指标差异均有统计学意义(P<0.05)。两组总生存期(OS)分别为15.2(95%可信区间:12.576～17.842)个月和16.1(95%可信区间:13.988～18.234)个月,差异无统计学意义。依立替康组生活质量(QOL)改善者有2例(8.0%),稳定者6例(24.0%),下降17例(68.0%);恩度组改善者有12例(60.0%),稳定者6例(30.0%),下降2例(10.0%),差异有统计学意义(P<0.01)。治疗的不良反应,依立替康组中性粒细胞减少、腹泻发生率明显高于恩度组(P<0.01)。结论:对奥沙利铂治疗无效或失败的晚期结直肠癌患者,卡培他滨联合依立替康或恩度是可供选择的方案,后者方案具有更好的疗效和安全性。
Objective： To evaluate the efficacy and safety of capecitabine combined with irinotecan or rh-endostatin （endostar） for the treatment of oxaliplatin-resistant patients with advanced colorectal cancer. Methods： Forty-five patients with oxaliplatin-resistant advanced colorectal cancer were included in this study. Twenty-five of them were treated with capecitabine combined with irinotecan and 20 of them were treated with capecitabine combined with endostar. Results： The follow-up period was 3-21 months. The response rate（RR） was 32.0% in irinotecan treated patients; the clinical benefit rate （CBR） was 72.0% ; time of tumor progression （TTP） was 6.2 （95% CI ： 3. 125 - 8. 905） months. The RR was 55.0% in endostar treated patients; the CBR was 90.0% and TlrP was 10.6 （95% CI： 7. 876 - 12. 962） months. There was significant difference between the two groups concerning the above three parameters （ P 〈 0.05 ）. The overall survival periods （OS） of the two groups were 15.2 （95 % CI ： 12. 576 - 17. 842） and 16.1 （95 % CI ： 13. 988 - 18. 234） months, respectively, with no significant difference （P 〉 0.05）. The quality of life （QOL） was improved in 2 cases （8.0%）, kept stable in 6 cases （24.0%）, and decreased in 17 cases （68.0%） in irinotecan treated group; the num- bers in the endostar treated group were 12 （60.0%）, 6 （ 30.0% ）, and 2 （ 10.0% ）, respectively, with significant difference between the two groups（P 〈 O. 01 ）. The incidences of drug-related adverse events, neutropenia and diarrhea, were higher in the irinotecan group than in the endostar group （P 〈0.01 ）. Conclusion： Capecitabine combined with iri- notecan or endostar are alternative therapies for oxaliplatin-resistant patients with advanced colorectal cancer, and capecitabine combined with endostar is more effective and safe.
出处
《中国肿瘤生物治疗杂志》
CAS
CSCD
北大核心
2009年第2期175-180,共6页
Chinese Journal of Cancer Biotherapy
基金
广东省医学科研资助项目(No.A2008450)~~
