奥沙利铂联合替吉奥治疗晚期胆道癌的临床观察_陈菊香

奥沙利铂联合替吉奥治疗晚期胆道癌的临床观察

陈菊香

周红轩朱利群潘琴

作者单位：213300江苏省溧阳市人民医院

【摘要】目的

观察奥沙利铂联合替吉奥治疗晚期胆道癌的临床疗效和不良反应。方法

选择经组织病理学确

诊的晚期胆道癌患者50例，分为观察组和对照组。观察组采用奥沙利铂130mg /m 2

，静脉滴注2h ，第1天；替吉奥胶囊

80 120mg /d ，每天2次，第1 14天；每21天为1个周期。对照组采用奥沙利铂130mg /m 2

，静脉滴注2h ，第1天；吉西他滨1000mg /m 2

，静脉滴注30min ，第1、

8天；每21天为1个周期。比较2组的临床疗效和不良反应。结果观察组

27例患者中CＲ0例，PＲ6例，SD 9例，PD 12例；ＲＲ22．2%，DCＲ55．6%，中位PFS 4．9个月，中位OS 9．7个月。对照组23例中CＲ0例，PＲ5例，SD 8例，PD 10例；ＲＲ21．7%，DCＲ56．5%，中位PFS 4．5个月，中位OS 9．5个月。2组相比，临床效果差异无统计学意义（P ＞0．05）。主要不良反应为白细胞下降、血小板下降、恶心呕吐、肝功能损害、外周神经毒性和皮疹等，多为Ⅰ Ⅱ度。观察组的血液学毒性和恶心、呕吐发生率低于对照组，差异有统计学意义（P ＜0．05）。结论

奥沙利铂联合替吉奥治疗晚期胆道癌临床疗效可靠，且不良反应较轻，值得深入研究。【关键词】奥沙利铂；替吉奥；吉西他滨；晚期胆道癌DOI ：10．3969/j．issn．1001-5930．2015．02．019中图分类号：Ｒ735．8

文献标识码：A

文章编号：1001-

5930（2015）02-0217-03Clinical Observation of Oxaliplatin plus S-1in the Treatment of Advanced

Biliary Tract Cancer

CHEN Juxiang ，ZHOU Hongxuan ，ZHU Liqun ，et al．

Liyang People ’s Hospital ，Liyang ，213300

【Abstract 】Objective

To evaluate the efficacy and adverse reactions of oxaliplatin plus S-1in the treatment of advanced

biliary tract cancer．Methods 50patients histologically confimed to be advanced biliary tract cancer were divided into the obser-vation group and the control group．The observation group was treated with oxaliplatin 130mg /m 2for 2h on the first day ，and S-1capsules 80 120mg /d ，twice a day on days 1 14，every 21days was 1cycle．The control group was treated with oxaliplatin 130mg /m 2for 2h on the first day ，and gemcitabine 1000mg /m 2for a 30minute infusion on day 1，8，every 21days was 1cycle．And clinical efficacy and adverse reactions of the 2groups were compared．Ｒesults

Among the 27patients in the observation

group ，

there was 0CＲ，6PＲ，9SD ，12PD ，the effective rate was 22．2%，disease control rate was 55．6%．And the median PFS and median OS were 4．9months and 9．7months ，respectively．Among the 23patients in the control group ，there was 0CＲ，5PＲ，8SD ，10PD．the effective rate was 21．7%，the disease control rate was 56．5%．And the median PFS and median OS were 4．5months and 9．5months ，respectively．There was no statistically significant difference between the 2groups （P ＞0．05）．The main adverse reactions were leukopenia ，thrombocytopenia ，nausea ，vomiting ，liver damage ，peripheral neurotoxicity and rash ，mostly Ⅰ Ⅱdegrees．The incidence of hematology toxicity ，nausea and vomiting in the observation group was lower than that of the con-trol group ，the difference was statistically significant （P ＜0．05）．Conclusion

Oxaliplatin plus S-1in the treatment of advanced

biliary tract cancer is effective ，and the adverse reactions is lighter ，it is worthy of further study．

【Key words 】Oxaliplatin ；S-1；Gemcitabine ；Advanced biliary tract cancer

（The Practical Journal of Cancer ，2015，30：217 219）

胆道癌是一种少见的起源于胆管上皮的恶性肿

瘤，其发生率占胃肠道肿瘤的4%左右［1］

。按组织结构分为肝内胆管癌、肝外胆管癌、胆囊癌和壶腹部癌。手术是唯一的根治方法，但大多数患者确诊时已为晚期，超过75%的患者无法手术；对于不能手术的晚期

胆道癌，姑息化疗相比最佳支持治疗可以明显改善患

者的生活质量、延长生存时间［2］

。目前尚无统一的标

准化疗方案，NCCN 指南推荐5-氟尿嘧啶或吉西他滨为基础的联合化疗作为一线方案治疗晚期胆道癌。我科采用奥沙利铂联合替吉奥胶囊或吉西他滨一线治疗晚期胆道癌患者，并进行临床对照试验，观察其临床疗效和不良反应，现报告如下。