Blanchard Pierre, Huguet Florence, André Thierry
Service d'oncologie radiothérapie, Hôpital Tenon, Paris.
Bull Cancer. 2007;94 Spec No Actualites:S104-15.
Gemcitabine is a well-tolerated anti-tumour drug with broad-spectrum activity. It is now recommended for treatment in an increasing number of tumours. Locally advanced or metastatic pancreatic cancer is the only digestive cancer for which it has yet been approved. Numerous phase III trials have addressed gemcitabine's dosage, infusion modalities, and its potential association with other anti-tumour drugs in pancreatic cancer. Standard recommended treatment for this disease in 2006 is gemcitabine monotherapy following Burris'protocol, that is 1000 mg per square meter in a 30 minute-infusion weekly for seven weeks, one week off and then weekly for three weeks, repeated every 4 weeks. Many phase I or II trials have been carried out in all other digestive cancers. They show gemcitabine's potential activity, especially in esophageal cancer, biliary tract adenocarcinoma and hepatocellular carcinoma. Nevertheless, larger studies are required to confirm this efficacy. The aim of this review is to describe the trials that have contributed to determine gemcitabine's infusion modalities in pancreatic cancer. We will then present the studies that have been carried out in other digestive cancers.
吉西他滨是一种耐受性良好的具有广谱活性的抗肿瘤药物。目前它被推荐用于越来越多肿瘤的治疗。局部晚期或转移性胰腺癌是唯一已批准使用该药物的消化道癌症。众多III期试验探讨了吉西他滨在胰腺癌中的剂量、输注方式及其与其他抗肿瘤药物联合使用的可能性。2006年，针对该疾病的标准推荐治疗方案是按照伯里斯方案进行吉西他滨单药治疗，即每平方米1000毫克，在30分钟内静脉输注，每周一次，共七周，休息一周，然后再每周一次，共三周，每4周重复一次。在所有其他消化道癌症中都开展了许多I期或II期试验。这些试验显示了吉西他滨的潜在活性，尤其是在食管癌、胆管腺癌和肝细胞癌中。然而，需要更大规模的研究来证实这种疗效。这篇综述的目的是描述有助于确定吉西他滨在胰腺癌中输注方式的试验。然后我们将介绍在其他消化道癌症中开展的研究。
