Boige V, Raoul J-L, Pignon J-P, Bouché O, Blanc J-F, Dahan L, Jouve J-L, Dupouy N, Ducreux M
Gastrointestinal Oncology Unit, Institut Gustave Roussy, Villejuif, France.
Br J Cancer. 2007 Oct 8;97(7):862-7. doi: 10.1038/sj.bjc.6603956. Epub 2007 Sep 18.
Evaluation of new drug combinations is needed to improve patients' prognosis in advanced hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the safety and efficacy of the capecitabine-oxaliplatine combination (XELOX) in HCC patients. First-line chemotherapy with XELOX regimen consisting of a 3-week cycle of intravenous oxaliplatin (130 mg m(-2)) on Day 1, and oral capecitabine twice daily from Days 1-14 (1000 mg m(-2)) was administered in patients with measurable, unresectable HCC. Fifty patients (male, 88%; median age, 68 years) received a total of 295 cycles (median, 6) of treatment. Disease control (three partial responses, 29 stable diseases) rate was 72% (95% CI 57-83%). Median overall and median progression-free (PFS) survival was 9.3 months and 4.1 months, respectively. Progression-free survival rates at 6 and 12 months were 38% (95% CI 26-52%) and 14% (95% CI 7-26%), respectively. Main grade 3-4 drug-related toxicities included diarrhoea (16%), elevation of aminotransferases and/or bilirubin (16%), thrombocytopenia (12%), and neurotoxicity (6%). Capecitabine plus oxaliplatin regimen showed modest anti-tumour activity with tolerable toxicities in patients with advanced HCC. However, the manageable toxicity profile and the encouraging disease control rate deserve further attention for this convenient, outpatient-based chemotherapy regimen.
需要评估新的药物组合以改善晚期肝细胞癌(HCC)患者的预后。本研究的目的是评估卡培他滨 - 奥沙利铂联合方案(XELOX)在HCC患者中的安全性和疗效。对可测量的不可切除HCC患者采用XELOX方案进行一线化疗,每3周为一个周期,第1天静脉注射奥沙利铂(130 mg m(-2)),第1 - 14天口服卡培他滨,每日两次(1000 mg m(-2))。50例患者(男性占88%;中位年龄68岁)共接受了295个周期(中位周期数为6)的治疗。疾病控制率(3例部分缓解,29例病情稳定)为72%(95%可信区间57 - 83%)。中位总生存期和中位无进展生存期(PFS)分别为9.3个月和4.1个月。6个月和12个月时的无进展生存率分别为38%(95%可信区间26 - 52%)和14%(95%可信区间7 - 26%)。主要的3 - 4级药物相关毒性包括腹泻(16%)、转氨酶和/或胆红素升高(16%)、血小板减少(12%)以及神经毒性(6%)。卡培他滨加奥沙利铂方案在晚期HCC患者中显示出适度的抗肿瘤活性,且毒性可耐受。然而,这种方便的门诊化疗方案可管理的毒性特征和令人鼓舞的疾病控制率值得进一步关注。