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吉西他滨联合奥沙利铂治疗晚期胰腺癌的疗效

[Efficacy of gemcitabine combined oxaliplatin on advanced pancreatic cancer].

作者信息

Shi Yan-Xia, Xu Rui-Hua, Jiang Wen-Qi, Zhang Li, Lin Tong-Yu, Li Yu-Hong, Xia Zhong-Jun, Luo Hui-Yan, Han Bing, Wang Feng, He You-Jian, Guan Zhong-Zhen

机构信息

State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, PR China.

出版信息

Ai Zheng. 2007 Dec;26(12):1381-4.

Abstract

BACKGROUND & OBJECTIVE: Gemcitabine (GEM) is efficient in treating advanced pancreatic cancer. Preliminary clinical studies showed that the efficacy of gemcitabine combined oxaliplatin (GEMOX regimen) is better than that of gemcitabine alone. But in China, the use of GEMOX regimen for advance pancreatic cancer has seldom been reported. This study was to analyze the efficacy of GEMOX regimen on advanced pancreatic cancer, and observe the adverse events.

METHODS

Clinical data of 32 chemonaive patients with stage III-IV pancreatic cancer, treated with GEMOX regimen [intravenous injection of gemcitabine (1 000 mg/m(2)) at Day 1 and Day 8, and intravenous injection of oxaliplatin (85-130 mg/m(2)) at Day 1; repeated every 21 days] at Cancer Center of Sun Yat-sen University from Feb. 2001 to Jun. 2006, were reviewed.

RESULTS

Of the 32 patients, 8 achieved partial remission (PR), 8 had stable disease (SD), and 12 had progressive disease (PD)û the objective responses were not assessable (NA) in 4 patients. The response rate was 25.0%, and the clinical benefit response (CBR) rate was 46.9% (15 patients). The progression-free survival (PFS) was 4.7 months; the median overall survival was 8.6 months; the 1-year survival rate was 32.6%. The total occurrence rate of myelosuppression was 70.9%û the occurrence rate of grade III-IV myelosuppression was 32.3%: 12.9% for anemia, 19.4% for neutropenia, and 22.6% for thrombocytopenia. The occurrence rate of gastrointestinal adverse events was 56.2%û only 2 patients had grade III vomiting. Liver function damage (grade I-II) occurred in 8 (25.0%) patients; peripheral neurotoxicity (grade I) occurred in 14 (43.8%) patients. No chemotherapy-related death occurred.

CONCLUSIONS

GEMOX is an effective regimen for pancreatic carcinoma with good clinical tolerance. The main adverse event is myelosuppression.

摘要

背景与目的

吉西他滨(GEM)对晚期胰腺癌治疗有效。初步临床研究表明,吉西他滨联合奥沙利铂(GEMOX方案)的疗效优于单用吉西他滨。但在中国,GEMOX方案用于晚期胰腺癌的报道较少。本研究旨在分析GEMOX方案对晚期胰腺癌的疗效,并观察不良事件。

方法

回顾性分析2001年2月至2006年6月在中山大学肿瘤防治中心接受GEMOX方案[第1天和第8天静脉注射吉西他滨(1000mg/m²),第1天静脉注射奥沙利铂(85 - 130mg/m²);每21天重复]治疗的32例初治III - IV期胰腺癌患者的临床资料。

结果

32例患者中,8例部分缓解(PR),8例病情稳定(SD),12例病情进展(PD);4例患者客观缓解无法评估(NA)。缓解率为25.0%,临床获益率(CBR)为46.9%(15例患者)。无进展生存期(PFS)为4.7个月;中位总生存期为8.6个月;1年生存率为32.6%。骨髓抑制总发生率为70.9%;III - IV级骨髓抑制发生率为32.3%:贫血12.9%,中性粒细胞减少19.4%,血小板减少22.6%。胃肠道不良事件发生率为56.2%;仅2例患者有III级呕吐。8例(25.0%)患者出现肝功能损害(I - II级);14例(43.8%)患者出现外周神经毒性(I级)。未发生化疗相关死亡。

结论

GEMOX方案对胰腺癌有效,临床耐受性良好。主要不良事件为骨髓抑制。

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