低剂量吉西他滨联合奥沙利铂方案在晚期尿路上皮癌化疗中的疗效和安全性分析
Effect of combined low dose Gemcitabine and Oxaliplatin in the treatment of advanced or metastatic urothelial carcinoma
目的 探讨低剂量吉西他滨联合奥沙利铂治疗浸润性和转移性尿路上皮癌的疗效和安全性.方法 回顾性分析2009年1月至2013年5月收治的42例经病理检查证实为肌层浸润性或转移性尿路上皮癌患者的资料,其中膀胱癌23例,输尿管癌11例,肾盂癌8例.化疗前Karnofsky评分均>60分.化疗方案为:吉西他滨700 mg/m2,第1、8、15天静脉滴注;奥沙利铂100 mg/m2,第2天静脉滴注;28 d为1个周期.结果 本组42例中,17例完成2个周期,19例完成4个周期,5例完成6个周期,1例因过敏反应仅完成1个周期.随访6~ 24个月,按WHO疗效评定标准:完全缓解7例(16.7%),部分缓解13例(30.9%),稳定14例(33.3%),进展8例(19.1%).随访6个月时有效率为47.6% (20/42),疾病控制率为80.9% (34/42).主要化疗不良反应:骨髓抑制,包括白细胞下降18例(42.9%),血小板下降16例(38.1%),贫血15例(35.7%);恶心、呕吐10例(45.2%);纳差、乏力20例(47.6%);脱发13例(30.9%).其中38例(90.5%)为轻、中度,Ⅲ度以上不良反应仅4例(9.5%),且化疗停止后很快缓解,未发生化疗相关死亡病例.结论 低剂量吉西他滨联合奥沙利铂治疗晚期尿路上皮癌安全有效,不良反应轻.
更多Objective To evaluate the therapeutic effect and toxicities of low dose Gemcitabine combined with Oxaliplatin in the treatment of advanced or metastatic uroedthelial carcinoma.Methods A total of 42 patients pathologically confirmed advanced or metastatic urothelial carcinoma (23 bladder cancer cases,11 ureteral carcinoma cases,and 8 renal pelvic carcinoma cases) were reviewed.Karnofsky score for each patient before treatment was more than 60.Combined treatment with Gemcitabine and Oxaliplatin regimen was as follows:Gemcitabine 700 mg/m2,iv infusion at day 1,8 and day 15,Oxaliplatin 100 mg/m2,iv infusion at day 2.The regimen was administered for more than 2 cycles (every 4 weeks) and the response rate was evaluated.The regimen was used in palliative chemotherapy and adjuvant chemotherapy,respectively.Results According to WHO evaluation criteria on therapeutic effectiveness,7 patients (16.7%) had complete response,13 patients (30.9%) had partial response,14 cases (33.3%) remained stable status,and 8 cases (19.1%) had progression.The overall response rate was 47.6%.The main side effects included thrombocytopenia,leucopenia,nausea,vomiting and alopecia,which were mild to moderate and disappeared when the chemotherapy was ceased.No chemotherapy related death occurred.Conclusions Combined treatment with low dose Gemcitabine and Oxaliplatin is effective for advanced or metastatic urothelial carcinoma,with mild and tolerable toxicities.
More- 浏览:599
- 被引:13
- 下载:392
相似文献
- 中文期刊
- 外文期刊
- 学位论文
- 会议论文