伊立替康+卡培他滨+塞来昔布治疗胆管癌治疗方案
本帖最后由 bluest 于 2011-12-15 11:34 编辑http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=36&abstractID=10202
http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=34&abstractID=34172
Background: There is no known effective chemotherapy regimen for patients with unresectable/metastatic cholangiocarcinoma. We are here to report a single institution, retrospective chart review on using a combination of irinotecan, capecitabine, and celecoxib in treating these patients.
Methods: From 9/03 to 11/04, 8 chemotherapy naive patients with a tissue diagnosis of unresectable/ cholangiocarcinoma were seen and treated with a regimen consisting of irinotecan 120mg/m2 on D1, capecitabine 1500mg/m2 D1-14 and celecoxib 200mg bid daily, Q21 days.
Results: Six females and two males, age 56-63 (median age=60), performance status(PS) between 0-2. A total of 64 treatments were given. Baseline CA 19-9 ranged from 86.9 - 6068 u/ml (normal < 33). 7 patients evaluable for CA19-9 response and treatment toxicity. A decline in CA19-9 was seen in 100% (5/7 > 80% decline). CT scan: 2/7 had stable disease and 2/7 had a minimum response (<20% decrease in target tumor size). Toxicity: diarrhea: 5/7 grade 0, 2/7 grade 1; hand-foot syndrome: 6/7 grade 0, 1/7 grade 1; anemia: 1/7 grade 0, 4/7 grade 1, 2/7 grade 2; neutropenia: 4/7 grade 0, 1/7 grade 1, 2/7 grade 2. No other grade III/IV non-hematological toxicity. All patients were alive as of 12/09/04 (1 - 15 months from initiation of treatment). Two patients remain working full time. Median response duration and median survival data have not matured.
Conclusions: XIC is well tolerated in patients with unresectable/metastatic cholangiocarcinoma and provides good palliative effects. A prospective phase II trial study with a dose-escalating scheme for irinotecan and quality of life assessment is being planned.
CA19-9 (u/ml) responses of the five patients in cohort B
患者情况 治疗前 最佳（周期） 结束（周期)
1 转移 6068.9 544.4 (8) 838.1 (10)
2 转移 4253.3 340.7 (11) 542.8 (15)
3 转移 135 20.7 (6) 22.8 (8)
4 转移 1362.7 263.9 (5) 465.7 (10)
5 局部进展 6029.1 3533 (3) 5770.5 (8)
CA19-9 response among the 7 evaluable patients
患者情况 治疗前 最佳（周期） 下降百分比 结束
1 转移 6068.9 521.3(12) 91 521.3
2 转移 4253.3 340.7(11) 92 833.4
3 转移 135 18.1(12) 87 18.1
4 转移 1326.7 263.9(5) 81 905.7
5 无转移 6029.1 3301.4(9) 46 10382.9
6 转移 294.9 259.9(1) 15 252.9
7 转移 4120.4 478.6(2) 88 478.6
二组伊立替康联合卡培他滨和塞来昔布的临床实验，耐受良好，7人组里CT显示2人稳定，2人缩小（幅度低于20%）。最后给出了几个患者治疗前后的CA199数据对比。 这个能拿给大夫看吗 hmysycn 发表于 2011-12-15 18:25 static/image/common/back.gif
这个能拿给大夫看吗
很少有医生愿意看这些 为什么会这样，知道了，也用不了 本帖最后由 bluest 于 2011-12-15 23:57 编辑
hmysycn 发表于 2011-12-15 21:43 static/image/common/back.gif
为什么会这样，知道了，也用不了
这些是国外的临床实验，你也可以和医生聊聊看一下他们的态度。
我估计结果会是：因为只是临床，还不能实际应用。 深蓝英文水平不错呀，我看的头都晕了。
百度一下塞来昔布是治疗关节炎的，这个也可以作为联合用药吗？ 阿彦 发表于 2011-12-15 23:25 static/image/common/back.gif
深蓝英文水平不错呀，我看的头都晕了。
百度一下塞来昔布是治疗关节炎的，这个也可以作为联合用药吗？
塞来昔布是COX-2抑制剂，COX-2与胆管癌发生和发展有很复杂的关系，下面的帖子里有一些说明。如你百度一下应该也可以查到国内有一篇塞来昔布治疗胆管癌的临床实验报告。
http://www.yuaigongwu.com/thread-4603-1-1.html 小鱼斗ICC 发表于 2012-1-22 14:46 static/image/common/back.gif
卡培他滨是希罗达吧？医生说这个确实是治疗ICC的药，就是以前的5-F，副作用应该不会很大。
塞来昔布曾经在 ...
找呕吐的原因，引流后胆红素和肝功指标如何，有没有吃大剂量止疼药，肿瘤有没有得到控制等等。 本帖最后由 bluest 于 2012-1-28 21:01 编辑
小鱼斗ICC 发表于 2012-1-24 15:02 static/image/common/back.gif
2011.12.28行第一次PTCD引流术，12.31管子不小心脱落；2012.01.09行第二次PTCD引流（肝左叶胆管内），引流前 ...
很明显胆红素和肝功处于高位就是呕吐的原因。必须成功引流，否则不仅呕吐，还会引起肝衰。 西乐葆怎么服用的呀楼主？
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