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腹腔内化疗治疗腹膜癌病可提高疗效且安全性可接受:41例患者200个周期的结果

Intraperitoneal chemotherapy for peritoneal carcinomatosis improves efficacy with acceptable safety: results of 200 cycles for 41 patients.

作者信息

Liu Yang, Yang Ting, Huang Chao-Qun, Li Guang, Li Yan

出版信息

Hepatogastroenterology. 2014 Mar-Apr;61(130):373-8.

Abstract

BACKGROUND/AIMS: To investigate the efficacy and safety of intraperitoneal (IP) chemotherapy for peritoneal carcinomatosis (PC).

METHODOLOGY

Forty-one PC patients received IP chemotherapy with carboplatin at 200 mg/m2 and docetaxel at 60 mg/m2 at 21-day intervals. Major organ functions were monitored. Changes in ascites and serum tumor markers (TM) were recorded. The primary endpoint was overall survival COS) and the secondary endpoint was adverse event (AE).

RESULTS

The patients received 200 cycles of IP chemotherapy, with a median of 5 IP chemotherapy cycles at the median duration of 5 months. The median follow-up was 19.5 months. For 25 patients with ascites, 15 cases had significant improvement, 9 had stable disease, and 1 had treatment failure. End-point events occurred in 31 patients, including 26 deaths from gastrointestinal PC with a median OS of 8.4 months (95%CI 4.6-12.2 months) and 5 deaths from other origins (median OS not reached). Multivariate analysis revealed the following independent OS-related factors: CC<1, primary tumor site, and decreases in CA125 and CEA for 2 consecutive cycles. Grade III toxicities included 16 cycles of digestive AE and 8 cycles of bone marrow suppression.

CONCLUSIONS

IP chemotherapy improves OS for PC patients with acceptable safety.

摘要

背景/目的:探讨腹腔内(IP)化疗治疗腹膜癌病(PC)的疗效和安全性。

方法

41例PC患者接受IP化疗,卡铂剂量为200mg/m²,多西他赛剂量为60mg/m²,每21天为一个周期。监测主要器官功能。记录腹水和血清肿瘤标志物(TM)的变化。主要终点为总生存期(OS),次要终点为不良事件(AE)。

结果

患者共接受200个周期的IP化疗,中位IP化疗周期数为5个,中位持续时间为5个月。中位随访时间为19.5个月。25例腹水患者中,15例有显著改善,9例病情稳定,1例治疗失败。31例患者发生终点事件,其中26例死于胃肠道PC,中位OS为8.4个月(95%CI 4.6 - 12.2个月),5例死于其他原因(中位OS未达到)。多因素分析显示以下与OS独立相关的因素:CC<1、原发肿瘤部位以及CA125和CEA连续2个周期下降。Ⅲ级毒性包括16个周期的消化系统AE和8个周期的骨髓抑制。

结论

IP化疗可改善PC患者的OS,安全性可接受。

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