【摘要】 背景与目的:卡培他滨单药治疗晚期消化道肿瘤有较好的疗效,采用常规推荐的用药方案,有部分患者不能耐受较严重的不良反应,需暂停用药或推迟下周期用药时间,从而影响生活质量和疗效。本临床研究采用将卡培他滨适当减量并延长用药时间至21d的方案治疗老年晚期消化道肿瘤,观察其临床疗效及不良反应。方法:31例老年晚期消化道肿瘤患者,分成对照组15例和常规用药组16例。对照组用药方法:卡培他滨每日2000mg/m2,分2次服,连用21d,4周重复;常规用药组用药方法:卡培他滨每日2500mg/m2,分2次服,连用14d,3周重复;2周期后评价疗效及不良反应。结果:对照组有效率33.3%,获益率73.3%;常规用药组有效率31.3%,获益率68.8%;两组间差异无统计学意义(P>0.05)。对照组手足综合征、恶心呕吐、口腔炎以及腹泻的发生率明显比常规用药组低(P<0.01),多是Ⅰ-Ⅱ度,而常规用药组不但发生率高,且Ⅲ-Ⅳ度不良反应的患者比例较多,部分患者需暂停用药或推迟下周期用药时间。结论:卡培他滨适当减量并延长用药时间至21d方案治疗老年晚期消化道肿瘤与常规的14d方案相比不良反应明显减小,耐受性更好,且不影响疗效。更多还原

【Abstract】 Background and purpose:Monotherapy using capecitabin(Xeloda) is effective for patients with advanced digestive tract cancer.However, due to intolerable side effects, capecitabin has been suspended or deferred in the patients who received its conventional regimens.In these cases, the curative effect and life quality of the patients were affected.In this clinical study, elderly patients with advanced digestive tract cancer were treated with a reduced dosage of capecitabin thereby extending their medication period to 21 days.The efficacy and toxicities of capecitabin was then observed in these patients.Methods:Thirty-one of the patients with advanced digestive tract cancer were randomly placed into the control group(n=15) or the conventional group(n=16).1 000 mg/m2 of oral capecitabin was administered twice daily(total 2 000 mg/m2 per day) for 21 days in the control group.The cycle was repeated every 4 weeks.1 250 mg/m2 of oral capecitabin was administered twice daily(total 2 500 mg/m2 per day) for 14 days in the conventional group.The cycle was repeated every 3 weeks.The efficacy and toxicities were evaluated after 2 cycles of treatment.Results:There were no significant differences in the response rates(33.3% vs 31.3%, P>0.05) and clinical benefit rates(73.3% vs 68.8%, P>0.05) between the control group and the conventional group.Incidences of hand-foot syndrome, nausea, vomiting, stomatitis and diarrhea were significantly lower in the control group in comparison to the conventional group(P<0.01).Most of the toxicities were grade Ⅰ and grade Ⅱ in the control group.Incidences of toxicities were higher in the conventional group than in the control group while the number of patients with grade Ⅲ and grade Ⅳ toxicities were greater in the conventional group rather than in the control group.The administration of capecitabin was nevertheless suspended or deferred in some patients in the conventional group due to severe side effects.Conclusion:When compared with the administration of capecitabin, which uses a 1 250 mg/m2 twice a day dosage(total 2 500 mg/m2 per day) over a 14-day period, extending the medication time to a 21-day period while reducing the dosage appropriately can reduce the negative side effects of capecitabin significantly by producing a better tolerance and the same efficacy in treatments for elderly patients with advanced digestive tract cancer.更多还原