Mambrini Andrea, Pacetti Paola, Del Freo Alfonso, Seta Roberta Della, Pezzuolo Debora, Torri Tito, Orlandi Massimo, Tartarini Roberta, Cantore Maurizio
Department of Oncology, Carrara city Hospital, piazza Sacco e Vanzetti, 54033 Carrara (MS), Italy.
Anticancer Res. 2009 May;29(5):1547-9.
Gemcitabine plus capecitabine are active in patients (pts) with advanced pancreatic cancer (APC). Intra-arterial chemotherapy showed activity and low toxicity. Combination of systemic and intra-arterial chemotherapy was investigated.
Patients with APC, progressed after a first-line chemotherapy, were included. Fixed doses of epirubicin 35 mg/m(2) and cisplatin 42 mg/m(2) intra-arterially every 28 days, and capecitabine 650 mg/m(2) twice a day on days 2-15; gemcitabine systemically in increasing doses on day 2. The purpose was to find maximum-tolerated dose (MTD) and dose-limiting toxicity (DLT).
Fifteen patients were enrolled. DLT occurred at 1300 mg/m(2) of gemcitabine and consisted of myelotoxicity (grade 4 febrile neutropenia and grade 4 thrombocytopenia).
Limiting toxicity was hematological. For further studies intra-arterial epirubicin 35 mg/m(2) and cisplatin 42 mg/m(2); systemic gemcitabine at 1,000 mg/m(2) on day 2, and capecitabine at 650 mg/m(2) twice a day PO on days 2-15 are suggested.
吉西他滨联合卡培他滨对晚期胰腺癌（APC）患者有效。动脉内化疗显示出活性且毒性较低。对全身化疗与动脉内化疗的联合应用进行了研究。
纳入一线化疗后病情进展的APC患者。每28天动脉内给予固定剂量的表柔比星35mg/m²和顺铂42mg/m²，在第2 - 15天口服卡培他滨650mg/m²，每日两次；在第2天全身给予递增剂量的吉西他滨。目的是确定最大耐受剂量（MTD）和剂量限制性毒性（DLT）。
纳入15例患者。DLT发生在吉西他滨剂量为1300mg/m²时，表现为骨髓毒性（4级发热性中性粒细胞减少和4级血小板减少）。
限制性毒性为血液学毒性。建议进一步研究采用动脉内给予表柔比星35mg/m²和顺铂42mg/m²；第2天全身给予吉西他滨1000mg/m²，第2 - 15天口服卡培他滨650mg/m²，每日两次。
