聚乙二醇多柔比星脂质体联合化疗治疗晚期恶性肿瘤临床观察

Clinical Observation of Pegylated Liposomal Doxorubicin in Combined Chemotherapy of Advanced Cancers

关键词:  聚乙二醇多柔比星脂质体  晚起恶性肿瘤  联合化疗

Key words:  pegylated liposomal doxorubicin  advanced cancer  combination chemotherapy

摘要:

目的 探讨以聚乙二醇多柔比星脂质体为主联合化疗治疗晚期恶性肿瘤的临床疗效和不良反应。方法 收集2007年1月—2009年11月以聚乙二醇多柔比星脂质体为主的联合化疗治疗晚期恶性肿瘤患者的治疗信息、临床情况，并对患者进行跟踪随访至2010年4月30日。结果 33例恶性肿瘤患者共计完成化疗106周期，中位3周期(1~8周期)，可评价疗效28例，其中完全缓解4例，占14.3%；部分缓解11例，占39.3%；稳定11例，占39.3%；进展2例，占7.1%；客观有效率为53.6%，临床受益率为92.9%。随访周期6~39个月，中位随访时间16个月，总生存时间4~39个月，中位生存时间16个月，无疾病进展时间2~39个月，中位无疾病进展时间为10个月，1和2年生存率分别为69.2%和34.2%，3例生存3年以上。不良反应主要为骨髓抑制、脱发和胃肠道反应，另外乏力、手足综合症常见，心脏毒性轻微。结论 以聚乙二醇多柔比星脂质体为主联合化疗治疗晚期恶性肿瘤是有效的，患者可以良好耐受。

Abstract:

OBJECTIVE To investigate the clinical response and adverse effects of combination chemotherapy based on pegylated liposomal doxorubicin(PLD) in advanced cancers treatment. METHODS A retrospective analysis was carried out in advanced cancer patients combined chemotherapy with pegylated liposomal doxorubicin from Jan, 2007 to Nov, 2009, and these patients were followed up till April 30, 2010. And the effiecy and safty of PLD were evaluated. RESULTS Thirty three patients had received 106 cycles of chemotherapy, 3 median cycles (range 1-8). Of the twenty-eight patients evaluated, 4 patients achieved complete response (14.3%), 11 patients partial response (39.3%), 11 patients stable disease (39.3%), and 2 patients progressive disease (7.1%). The objective response rate was 53.6% and the clinical benefit rate was 92.9%. The median follow-up time for the patients was 16 months (ranging from 6 to 39 months). Survival time interval of these patients were from 4 to 39 months, the median survival time was 16 months, progression-free survival 2-39 months, the median progression-free survival 10 months, the one- and the two-year survival rate was 69.2% and 34.2%, respectively, 3 cases of patients survived more than 3 years. The major adverse effects were myelosuppression, alopecia and gastrointestinal reaction. Asthenia and hand-foot syndrome were observed. Cardiac toxicity seldom occurred. CONCLUSION The combination chemotherapy based on pegylated liposomal doxorubicin in advanced cancers is efficient and well tolerated.