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卡培他滨治疗晚期肝细胞癌:多中心经验。

Capecitabine in advanced hepatocellular carcinoma: A multicenter experience.

机构信息

Department of Surgical, Oncological and Gastroenterological Sciences, Unit of Gastroenterology, University of Padova, Via Giustiniani 2, 35128 Padova, PD, Italy.

Department of Clinical and Experimental Oncology, Unit of Medical Oncology 1, Istituto Oncologico Veneto - IRCCS, Via Gattamelata 64, 35128 Padova, PD, Italy.

出版信息

Dig Liver Dis. 2019 Dec;51(12):1713-1719. doi: 10.1016/j.dld.2019.06.015. Epub 2019 Jul 16.

Abstract

BACKGROUND

Recent data suggest a potential activity and a good tolerability of capecitabine in advanced hepatocellular carcinoma (HCC).

AIMS

To evaluate capecitabine activity and safety in a wide cohort of advanced HCC patients.

METHODS

Retrospective analysis of 143 capecitabine-treated patients (January 2010 to December 2017) in three centers of the Veneto Oncology Network.

RESULTS

Capecitabine was administered in second and third line, but also in first line instead of sorafenib in Child-Pugh B patients (70%), compromised clinical conditions (14%) or contraindications to antiangiogenetics (16%). Median overall survival (OS) and time to progression (TTP) were 6.9 and 2.8 months, respectively. There were no differences in OS and TTP between the 32 patients treated with non-metronomic scheme (2000 mg/day for 14 days) and the 111 patients treated with metronomic scheme (1000 mg/day) after correction for prognostic factors at baseline with a propensity score analysis. Capecitabine was more active in patients intolerant to sorafenib than in those progressing during treatment (p = 0.024). At least one adverse event (mainly hematological) was experienced by 73% of patients but discontinuation was necessary only in 11 (8%).

CONCLUSIONS

Capecitabine can be considered an active and safe option in advanced HCC, especially for patients unfit for other treatments.

摘要

背景

最近的数据表明,卡培他滨在晚期肝细胞癌(HCC)中具有潜在的活性和良好的耐受性。

目的

评估卡培他滨在广泛的晚期 HCC 患者中的活性和安全性。

方法

回顾性分析了三个威尼托肿瘤网络中心的 143 例卡培他滨治疗的患者(2010 年 1 月至 2017 年 12 月)。

结果

卡培他滨主要用于二线和三线治疗,但也有 70%的患者在 Child-Pugh B 级、14%的患者在临床状况不佳或有抗血管生成药物禁忌证的情况下用于一线治疗,以替代索拉非尼。中位总生存期(OS)和无进展生存期(TTP)分别为 6.9 个月和 2.8 个月。在对基线预后因素进行倾向性评分分析校正后,两组患者(非节拍方案:14 天每天 2000mg;节拍方案:每天 1000mg)之间的 OS 和 TTP 无差异。在节拍方案组和非节拍方案组中,与治疗进展的患者相比,不能耐受索拉非尼的患者中卡培他滨的活性更高(p=0.024)。73%的患者至少经历了一次不良反应(主要是血液学毒性),但只有 11 例(8%)需要停药。

结论

卡培他滨在晚期 HCC 中是一种有效且安全的选择,尤其是对不适合其他治疗的患者。

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