卡培他滨联合多西紫杉醇节拍化疗治疗转移性乳腺癌临床研究

目的探讨卡培他滨联合多西紫杉醇节拍化疗治疗转移性乳腺癌临床疗效与安全性。方法20例转移性乳腺癌病例,卡培他滨采用500 mg tid,连续口服第1-14天;国产多西紫杉醇25 mg.m^-2,静脉滴注持续1 h,第1、8 d给药。每21 d重复。结果20例中CR1例,PR11例,SD4例,PD4例,RR为60%（12/20）,DCR为80%（16/20）。不良反应为Ⅰ-Ⅱ度白细胞下降、关节肌肉酸痛及手足综合征,Ⅰ度消化道反应,Ⅲ度不良反应少见,无Ⅳ度不良反应。结论应用卡培他滨联合多西紫杉醇节拍化疗治疗转移性乳腺癌,具有疗效好、副作用小及患者依从性好等优点。     

吉西他滨联合卡培他滨治疗蒽环类耐药的转移性乳腺癌的临床疗效和安全性分析

目的分析吉西他滨联合卡培他滨治疗蒽环类耐药的转移性乳腺癌的临床疗效和安全性。方法将2008年6月至2012年6月我院收治的91例对蒽环类耐药的转移性乳腺癌患者为研究对象,并将其随机分为两组,即吉西他滨组45例,给予吉西他滨联合卡培他滨治疗,多西紫杉醇组46例,给予多西紫杉醇联合卡培他滨治疗,21天为1疗程,每疗程进行毒副作用评估,两组均治疗2疗程后对比临床疗效。结果吉西他滨组的总缓解率(44.44%)明显高于多西紫杉醇组(21.74%)(P<0.05);吉西他滨组Ⅲ、Ⅳ度骨髓抑制发生率(17.78%)和Ⅲ、Ⅳ度消化道毒副作用发生率(20.00%)均明显低于多西紫杉醇组(39.13%,43.48%)(P<0.05)。结论吉西他滨联合卡培他滨治疗蒽环类耐药的转移性乳腺癌疗效较多西紫杉醇联合卡培他滨更好,且不良反应的发生率更低,值得临床推广。     

多西他赛联合卡培他滨治疗30例转移性乳腺癌临床观察

目的观察多西他赛联合卡培他滨治疗转移性乳腺癌疗效及毒副反应。方法自2007年7月至2011年1月对30例转移性乳腺癌采用多西他赛联合卡培他滨方案化疗,多西他赛75mg/m2第1天静点,卡培他滨1000mg/m2,2次/d口服,第1～14天,21d为一周期,应用2周期后观察其疗效及毒副反应。结果 30例中29例完成化疗,其中CR1例,PR14例,SD10例,PD4例,有效率（CR＋PR）为51.17%。毒副反应主要为白细胞下降（82.76%）,其他毒副反应包括手足综合征（48.28%）,胃肠道反应（41.38%）,乏力（20.69%）。结论多西他赛联合卡培他滨方案治疗转移性乳腺癌疗效满意,毒副作用可以耐受。     

脾多肽联合卡倍他滨/多西紫杉醇治疗蒽环类失败复发转移性乳腺癌的疗效观察

目的 评价脾多肽对采用以卡倍他滨/多西紫杉醇联合化疗方案治疗的蒽环类失败复发转移性乳腺癌的辅助疗效.方法 将63例蒽环类失败复发转移性乳腺癌患者按随机号码表法随机分为两组：脾多肽（斯普林）组（32例）：脾多肽联合卡倍他滨＋多西紫杉醇;对照组（31例）：单用卡倍他滨＋多西紫杉醇.脾多肽组于开始使用联合化疗方案时即行脾多肽（斯普林）10 ml/d（含25 mg多肽）静脉滴注,连续应用4周.分别于治疗前后对患者外周血白细胞、血小板、血红蛋白水平、肝肾功能、食欲、消化道反应、体质量、Karnofsky评分、免疫功能、疗效进行评价.结果 脾多肽组及对照组的总有效率分别是71.9%及54.8%（P=0.014）.脾多肽组及对照组中位生存时间分别为15.9个月及11.3个月（P=0.026）.1年生存率在脾多肽组及对照组分别为51.6%及38.7%（P=0.035）.脾多肽组白细胞、血小板及血红蛋白水平减少程度均好于对照组;免疫指标NK细胞活性,及CD3、CD4、CD8阳性细胞百分率,CD4/CD8比值显著提高（P＜0.05）.结论 脾多肽联合卡倍他滨/多西紫杉醇联合化疗治疗蒽环类失败复发转移性乳腺癌可以增加疗效,减轻骨髓毒性、疼痛及消化道反应,提高机体免疫力,提高患者生存质量和化疗耐受性值得临床推广.     

吉西他滨联合卡培他滨治疗复发转移性乳腺癌的临床观察

目的观察吉西他滨联合卡培他滨治疗复发转移性乳腺癌的临床疗效及不良反应。方法 32例蒽环类及紫杉类药物治疗失败的复发转移性乳腺癌患者接受吉西他滨联合卡培他滨治疗：吉西他滨1 000 mg·m-2,静脉滴注第1,8天;卡培他滨1 250 mg·m-2,口服,2次/日,第1~14天,每21 d为1周期,每2个周期评价疗效,最终观察目的为PFS及药物毒副反应。结果 32例患者中完全缓解（CR）3例,部分缓解（PR）11例,ORR为43.75%;中位PFS达7.5个月。主要不良反应为血液系统毒性：Ⅲ~IV度粒细胞减少发生率为42.5%;手足综合征发生率38.2%,胃肠道反应28.3%,无化疗相关死亡病例。结论吉西他滨联合卡培他滨治疗复发转移性乳腺癌近期疗效肯定,耐受良好,远期疗效有待进一步观察。     

多西他赛联合卡培他滨治疗复发转移性乳腺癌的临床疗效观察

目的观察多西他赛联合卡培他滨治复发转移性乳腺癌的近期临床疗效及其不良反应。方法 32例复发转移性乳腺癌患者应用多西他赛75mg/m2静滴,第1d;卡培他滨1200mg/m2口服,2次/d,第1~14d。21d为1个周期,至少2周期后评价近期临床疗效和不良反应。结果所有患者中CR2例(6.3%),PR15例(46.9%),SD10例(31.3%),PD5例(15.6%);RR为53.1%,CBR为84.4%。不良反应主要为恶心与呕吐、粒细胞减少、手足综合征,多为Ⅰ~Ⅱ度。结论卡培他滨联合多西他赛治疗复发转移性乳腺癌临床疗效确切,不良反应可以耐受,可以作为晚期乳腺癌有效的治疗方案。     

多西紫杉醇联合卡培他滨治疗蒽环类耐药性晚期乳腺癌的临床观察

目的观察多西紫杉醇联合卡培他滨治疗蒽环类耐药性晚期乳腺癌的疗效和不良反应。方法蒽环类药物治疗失败的晚期乳腺癌患者32例,接受卡培他滨和多西紫杉醇联合方案化疗。卡培他滨2000mg/(m2.d),第1～14天;多西紫杉醇25～30mg/m2,第1、8、15天,21d为1个疗程,至少治疗2个疗程。结果完全缓解4例,部分缓解11例,稳定12例,进展5例,总有效率46.9%,平均TTP5.5个月。主要不良反应为骨髓抑制,胃肠道反应和手足综合征,Ⅲ Ⅳ度白细胞下降15.6%,其余多为Ⅰ～Ⅱ毒性反应。结论多西紫杉醇联合卡培他滨治疗蒽环类药物耐药的晚期乳腺癌,有较好的疗效,毒性可以耐受,为有效的解救方案。     

卡培他滨与表柔比星分别联合多西紫杉醇治疗转移性乳腺癌临床疗效及生活质量分析

目的:对转移性乳腺癌患者应用卡培他滨、表柔比星分别和多西紫杉醇联合医治的临床疗效及生活质量进行分析。方法:对某院2015年6月~2018年6月诊治转移性乳腺癌112例患者临床资料加以分析,按照临床不同医治方案分成两组,将56例行表柔比星和多西紫杉醇联合医治患者设为对照组,将56例行卡培他滨和多西紫杉醇联合医治患者设为观察组,对两组临床疗效、毒副反应及生活质量进行比对、分析。结果:观察组总有效率(96.43%)比对照组(80.36%)高,且毒副反应总发生率(8.93%)比对照组低(P0.05);观察组总体健康得分较对照组高(P0.05)。结论:对转移性乳腺癌患者应用卡培他滨和多西紫杉醇联合医治疗效显著,可减少毒副反应发生,且提高患者生活质量。     

比较多西紫杉醇联合卡培他滨与奥沙利铂联合卡培他滨治疗晚期胃癌的近期疗效

目的比较多西紫杉醇联合卡培他滨与奥沙利铂联合卡培他滨治疗晚期胃癌的近期疗效。方法选取本院收治的78例晚期胃癌患者,根据不同化疗方案将其分为对照组(多西紫杉醇联合卡培他滨治疗,n=31)和观察组(奥沙利铂联合卡培他滨治疗,n=31),化疗2个周期后比较两组的近期疗效和不良反应发生率。结果对照组治疗有效率为48.72%,观察组为53.85%,两组的治疗有效率对比无显著差异(P> 0.05);对照组不良反应发生率为46.15%,观察组为38.46%,组间不良反应发生率对比无明显差异(P> 0.05),无化疗不耐受中途退出病例。结论多西紫杉醇联合卡培他滨与奥沙利铂联合卡培他滨治疗晚期胃癌疗效相当,安全性相近,患者均可耐受化疗。     

多西他赛联合卡培他滨治疗转移性乳腺癌的临床观察及护理

目的对多西他赛联合卡培他滨治疗转移性乳腺癌的临床治疗和护理效果进行研究。方法对本院2011.8～2012.8期间在本院乳腺外科治疗的100例转移性乳腺癌改良根治术后接受化疗的患者进行分组治疗和护理,观察组(60例)和对照组(40例),观察组前四周期采用CEF方案,后4周期单用多西他赛治疗方案治疗,对照组八个周期均采用CEF方案治疗,观察组采取护理路径进行护理,对照组采取常规护理。结果观察组多西他赛联合卡培他滨治疗转移性乳腺癌的无病生存率和总生存率为(78.33%和91.67%),显著高于未使用多西他赛治疗的对照组(70%和82.5%),P<0.05,提示两组近期有效率存在显著差异性,有统计学意义。护理路径的实施对于提高患者依从性有积极的意义。结论多西他赛联合卡培他滨治疗转移性乳腺癌的疗效确切,且护理路径的实施效果较好,值得临床推广应用。     

替吉奥与卡培他滨分别联合多西他赛治疗转移性乳腺癌的临床研究

目的：比较替吉奥联合多西他赛及卡培他滨（希罗达）联合多西他赛治疗转移性乳腺癌的临床疗效。方法将88例转移性乳腺癌患者采用随机数字表法分成观察组和对照组,每组44例。治疗组应用替吉奥联合多西他赛进行治疗,对照组应用希罗达联合多西他赛进行治疗。比较两组患者临床总有效率、无进展生存期、生活质量及不良反应发生率。结果观察组总有效率为75．00％,高于对照组的38．64％（χ2＝2.199,P＜0．05）。观察组患者无进展生存期达（10．53±3．21）个月,长于对照组的（5．72±2．10）个月（t＝0.667,P＜0．05）。随访3个月后,观察组患者躯体、社会支持、心理、精神等4个因子各项评分均明显优于对照组（ t＝2．885、2．326、3．379、5．503,均P＜0．05）。结论替吉奥联合多西他赛治疗转移性乳腺癌临床疗效确切,不良反应可耐受,临床上可作为转移性乳腺癌化疗的新方案。     

多西他赛联合卡培他滨治疗复发转移乳腺癌的不良反应分析及药学监护

目的探究多西他赛联合卡培他滨治疗复发转移乳腺癌的不良反应及药学监护,研究药学监护的应用价值。方法 80例复发转移乳腺癌患者,按数字法随机分为观察组与对照组各40例,观察组给予多西他赛联合卡培他滨治疗,并由临床药师进行药学监护。对照组给予多西他赛联合卡培他滨治疗。观察两组患者不良反应情况及满意度。结果观察组患者中出现白细胞减少、手足综合征、血小板减少、恶心呕吐、迟发型腹泻、脱发等情况明显少于对照组,差异有统计学意义（P〈0.05）;观察组患者满意度明显高于对照组,差异有统计学意义（P〈0.05）。结论多西他赛联合卡培他滨治疗复发转移乳腺癌临床效果确切,且进行药学监护能给患者进行针对性指导,有效降低不良反应的发生,提高患者的满意度,值得在临床上推广与应用。     

多西紫杉醇联合卡培他滨新辅助化疗13例局部晚期乳腺癌的观察

目的探讨多西紫杉醇联合卡培他滨新辅助化疗方案治疗局部晚期乳腺癌的疗效及安全性。方法 13例局部晚期乳腺癌初治患者,卡培他滨药2500 mg/(m2?d),分早晚2次,餐后30 min口服。连续服用2周,休息1周为1个周期。多西紫杉醇75 mg/m2,静脉输注1 h滴完。21 d为1个周期,2周期后评价疗效。结果 13例局部晚期乳腺癌中治疗后完全缓解4例,部分缓解6例,稳定2例,进展1例,有效率76.92%(10/13),主要不良反应为白细胞减少,发生率为82.33%,其中Ⅲ度占29.61%,没有发现有Ⅳ度。结论多西紫杉醇联合卡培他滨新辅助化疗方案治疗局部晚期乳腺癌疗效确切,不良反应可耐受。     

多西他赛联合卡培他滨治疗复发转移乳腺癌的不良反应及药学监护

目的：针对多西他赛联合卡培他滨治疗复发转移乳腺癌的不良反应及药学监护过程,探讨临床药师在肿瘤患者药物治疗中的作用。方法：收集2011年7月-2013年3月临床药师监护下的26例复发转移乳腺癌患者,该26例患者均接受多西他赛联合卡培他滨方案化疗（第1天,多西他赛75mg／m^2,静脉滴注＋第1～14天,卡培他滨950mg／m^2,bid,口服。21d为1个周期）。临床药师在用药辅导、预服地塞米松、胃肠道反应、口腔黏膜溃疡、手足综合征、骨髓抑制等方面为患者提供药学服务,预防和解决化疗相关不良反应。结果：临床药师为患者制订了个体化治疗方案,患者在顺利完成化疗的同时,不良反应显著降低。结论：临床药师对肿瘤患者提供药学服务,可显著提高患者的生活质量。     

Hand-foot syndrome in patients treated with capecitabine-containing combination chemotherapy

Clinical characteristics and risk factors of hand-foot syndrome were investigated in patients who received capecitabine-containing chemotherapy. Toxicity data were analyzed from 179 patients in 4 prospective clinical trials testing docetaxel/capecitabine/cisplatin in stomach cancer, capecitabine/cisplatin in biliary or stomach cancer, and vinorelbine/capecitabine in breast cancer. Hand-foot syndrome was reported in 116/179 (64.8%) of patients, with grade 3 hand-foot syndrome in 8/179 (4.5%). Hand-foot syndrome first developed within the first 3 chemotherapy cycles in 100/116 (86.2%) patients, with the median onset for all 3 treatment regimens occurring during cycle 2. Because severe reactions were rare, hand-foot syndrome was not a major factor influencing treatment schedule. Risk factor analyses showed that combined use of docetaxel and preceding chemotherapy-related stomatitis were significant risk factors for the development of hand-foot syndrome. Our results suggest that a combined treatment agent and a patient's susceptibility to chemotherapy-related toxicity may increase the risk of capecitabine-induced hand-foot syndrome.     

Capecitabine: new indication. In breast cancer: inadequately assessed

There is no consensus on treatment of locally advanced or metastatic breast cancer after failure of first-line cytotoxic chemotherapy. Common options are continuous infusion of a taxane (docetaxel or paclitaxel), vinorelbine or fluorouracil. Capecitabine is now licensed for use in breast cancer, both in combination with IV docetaxel after anthracycline failure, and as single-agent therapy after failure of anthracyclines and taxanes. The clinical evaluation dossier on capecitabine fails to answer the most important questions about comparative efficacy and safety. In second-line treatment, after anthracycline failure, the only available comparative trial showed that the capecitabine + docetaxel combination increased median survival time by about three months relative to placebo + docetaxel, but caused more adverse events. There are no trials comparing capecitabine with other options. There is no evidence that capecitabine increases the length or quality of survival, relative to intravenous vinorelbine, in women with breast cancer that is resistant to both anthracyclines and taxanes. The classical adverse effects of capecitabine are also observed in women with breast cancer, namely palmoplantar erythrodysesthesia, diarrhoea, nausea and vomiting, and major hyperbilirubinemia. Capecitabine can be taken by mouth and this may be an advantage. However, current evidence is too limited to justify using capecitabine outside of clinical trials.     

Capecitabine: a review of its pharmacology and therapeutic efficacy in the management of advanced breast cancer

Capecitabine is an orally administered prodrug of fluorouracil which is indicated in the US and Europe, in combination with docetaxel, for the treatment of patients with metastatic breast cancer failing anthracycline therapy, and as monotherapy for metastatic breast cancer resistant to paclitaxel and anthracycline therapy (US) or failing intensive chemotherapy (Europe). Capecitabine is also approved for use in metastatic colorectal cancer. Capecitabine is metabolically activated preferentially at the tumour site, and shows antineoplastic activity and synergy with other cytotoxic agents including cyclophosphamide or docetaxel in animal models. Bioavailability after oral administration is close to 100%. In patients with pretreated advanced breast cancer, capecitabine is effective as monotherapy and also in combination with other agents. Combination therapy with capecitabine 1,250 mg/m(2) twice daily for 2 weeks of every 3-week cycle plus intravenous docetaxel 75 mg/m(2) on day one of each cycle was superior to intravenous monotherapy with docetaxel 100 mg/m(2) on day one of each cycle. Capecitabine plus docetaxel significantly reduced the risks of disease progression and death by 35% (p = 0.0001) and 23% (p < 0.05), respectively, and significantly increased median survival (p < 0.05) and objective response rates (p < 0.01). Efficacy has also been demonstrated with capecitabine monotherapy and combination therapy in previously untreated patients in preliminary trials. The most common adverse effects occurring in patients receiving capecitabine monotherapy include lymphopenia, anaemia, diarrhoea, hand-and-foot syndrome, nausea, fatigue, hyperbilirubinaemia, dermatitis and vomiting (all >25% incidence). While gastrointestinal events and hand-and-foot syndrome occurred more often with capecitabine than with paclitaxel or a regimen of cyclophosphamide, methotrexate and fluorouracil (CMF), neutropenic fever, arthralgia, pyrexia and myalgia were more common with paclitaxel, and nausea, stomatitis, alopecia and asthenia were more common with CMF. The incidence of adverse effects and hospitalisation was similar in patients receiving capecitabine plus docetaxel and those receiving docetaxel monotherapy. In conclusion, capecitabine, an oral prodrug of fluorouracil which is activated preferentially at the tumour site, is an effective and convenient addition to the intravenous polychemotherapeutic treatment of advanced breast cancer in pretreated patients, and also has potential as a component of first-line combination regimens. Combined capecitabine plus docetaxel therapy resulted in similar rates of treatment-related adverse effects and hospitalisation to those seen with docetaxel monotherapy. Capecitabine is also effective as monotherapy in pretreated patients and phase II data for capecitabine as first-line monotherapy are also promising. While gastrointestinal effects and hand-and-foot syndrome occur often with capecitabine, the tolerability profile was comparatively favourable for other adverse effects (notably, neutropenia and alopecia).