Efficacy and safety of capecitabine as maintenance treatment after first-line chemotherapy using oxaliplatin and capecitabine in advanced gastric adenocarcinoma patients: a prospective observation
Efficacy and safety of capecitabine as maintenance treatment after first-line chemotherapy using oxaliplatin and capecitabine in advanced gastric adenocarcinoma patients: a prospective observation
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卡培他滨作为奥沙利铂和卡培他滨一线化疗后维持治疗晚期胃腺癌患者的疗效和安全性：前瞻性观察
DOI：
10.1007/s13277-013-1574-5
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发表时间：
2014-05-01
期刊：
影响因子：
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通讯作者：
Xu, Rui-hua
中科院分区：
文献类型：
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作者：
Qiu, Miao-zhen;Wei, Xiao-li;Xu, Rui-hua
一线化疗后维持治疗的价值在肺癌和结直肠癌中已得到验证，但在胃癌中，维持治疗的作用仍有待解答。本研究的目的是评价卡培他滨作为一线化疗后维持治疗在中国晚期胃腺癌患者中的疗效和安全性。收集接受奥沙利铂加卡培他滨（Xelox）一线化疗6个周期、无疾病进展、神经病变2级及以上的晚期胃腺癌患者标本进行分析。其中，A组64例患者接受卡培他滨维持治疗，b组222例患者未接受维持治疗，采用Cox回归模型进行生存分析。3-4级不良事件不常见；血液毒性不常见（5%），在维持治疗阶段一直很轻微。A组患者的中位无进展生存期（PFS）为11.4个月[95%可信区间（CI）， 10.2-12.6个月]，而B组患者的中位无进展生存期为7.1个月（95% CI, 6.1-8.0个月），P< 0.001。多因素分析显示，维持治疗是影响晚期胃腺癌患者预后的独立因素。一线治疗-维持治疗（Xelox-X）对于患有2级或以上神经病变的晚期胃腺癌患者是积极可行的。
The value of maintenance therapy after first-line chemotherapy has been verified in lung cancer and colorectal cancer, however, in gastric cancer, the role of maintenance therapy is still waiting for an answer. The aim of this study is to evaluate the efficacy and safety of capecitabine as maintenance treatment after first-line chemotherapy in advanced gastric adenocarcinoma patients in China. Specimens of patients with advanced gastric adenocarcinoma who were given 6 cycles of oxaliplatin and capecitabine (Xelox for short) as first-line chemotherapy, without disease progression and with grade 2 or higher neuropathy, were collected for analysis. Among them, 64 patients received capecitabine as maintenance (group A) and 222 patients without maintenance as group B. Survival analysis was performed with a Cox regression model. Grades 3–4 adverse events were uncommon; hematologic toxicity was infrequent (5 %) and consistently mild in the phase of maintenance treatment. The median progression-free survival (PFS) was 11.4 months [95 % confidence interval (CI), 10.2–12.6 months] for group A patients, while it was 7.1 months (95 % CI, 6.1–8.0 months) for patients in group B,P< 0.001. The multivariated analysis showed that the maintenance treatment was an independent prognostic factor in advanced gastric adenocarcinoma patients. The style of first-line treatment-maintenance therapy (Xelox-X) was active and feasible for advanced gastric adenocarcinoma patients who had suffered from grade 2 or higher level of neuropathy.