Objective To systematically evaluate the clinical effectiveness and safety of capecitabine plus docetaxel in the treatment of patients with metastatic breast cancer where anthracycline has failed as a treatment. Methods We electronically searched PubMed, EMBASE, the Cochrane Library (2008, issue 4), and CBM to Sept. 2008. Randomized controlled trials (RCTs) and quasi-RCTs about capecitabine plus docetaxel combination therapy in anthracycline-pretreated patients with metastatic breast cancer were identified. Study selection and analyses were undertaken according to the Cochrane Handbook, and RevMan 5.0 was applied for statistical analyses. The following was studied: total survival time, the development time of disease, reaction rate, the mid-survival time, adverse events and quality of life. Results Three RCTs involving 672 patients with metastatic breast cancer were included. The results of meta-analyses showed that the overall survival (MD=3.00, 95%CI 1.64 to 4.36), disease time to progression (MD=1.85, 95%CI 1.15 to 2.55), and the response rate (RR=1.29, 95%CI 1.09 to 1.52) were superior in the combination arm to the docetaxel alone arm. Conclusion The current evidence available shows that the combination of capecitabine and docetaxel may significantly improve the short-term efficacy comparing with docetaxel alone. However, adverse events and long-term efficacy are not clear; more high-quality RCTs should be conducted.
Objective To formulate an evidence-based nursing methods for a patient with grade III handfoot syndrome induced by capecitabine. Methods Based on the cl inical questions, we searched The Cochrane Library (Issue 1, 2008), ACP Journal Club (1991 to January 2008), MEDLINE (1996 to 2008) and CBMdisc (1995 to 2008). The retrieved studies were further critically appraised. Results There were two effective measures in patients with grade III hand-foot syndrome induced by capecitabine: ① Treatment interruption or dose reduction with supportive measures to reduce pain and discomfort and prevent secondary infection. ② Using Traditional Chinese Medicine and no need of treatment interruption or dose reduction. With patients preference, Treatment interruption and supportive measures were administered to the patient. After two weeks, the patient had a complete response. Conclusions To patients with grade III hand-foot syndrome induced by capecitabine, treatment interruption and supportive measures are effective nursing methods.
目的 比较草酸铂联合氟尿嘧啶/亚叶酸钙 （FOLFOX4）与草酸铂联合卡培他滨（XELOX）治疗晚期结直肠癌的临床疗效。 方法 将2007年1月－2011年12月收治的58例转移或复发晚期结直肠癌患者按照化学疗法（化疗）方案的不同分为两组，其中FOLFOX4组28例（男性患者占57.1%，平均年龄56.3岁），XELOX组30例（男性患者占63.3%，平均年龄57.8岁）。所有患者疗程不少于2个化疗周期，评价指标为病情缓解率和化疗药物的毒副作用。 结果 FOLFOX4组完全缓解率（CR）和部分缓解率（PR）分别为10.7%（3/28）和32.1%（9/28），总有效率为42.8%（12/28）；XELOX组CR和PR率分别为13.3%（4/30）和30.0%（9/30），总有效率为43.3%（13/30），两组总有效率差异无统计学意义（P=0.971）。XELOX组有10.0%（3/30）和16.7%（5/30）的患者分别出现中性粒细胞降低和神经毒性，但均显著低于FOLFOX4组[39.3%（11/28）、43.3%（13/30）]（P=0.009，0.014）。XELOX组手足综合症发生率明显高于FOLFOX4组[40.0%（12/30）、14.5（4/28），P=0.029），但程度较轻, 主要为Ⅰ～Ⅱ度。 结论 XELOX与FOLFOX4化疗方案治疗晚期结直肠癌患者的疗效相似，但XELOX化疗方案毒副反应相对较小。
目的 评价卡培他滨+伊立替康与氟尿嘧啶/醛氢叶酸（5-FU/LV）+伊立替康治疗转移性结直肠癌的有效性和安全性。 方法 计算机检索PubMed、CENTRAL、Embase、中国生物医学数据库、中国期刊全文数据库、维普数据库和万方数据库，检索时间均从建库至2011年9月。对符合纳入标准的随机对照试验进行质量评价和Meta分析。 结果 纳入3个随机对照试验，共计419例患者，卡培他滨+伊立替康在中位生存期、完全缓解率[RR=1.58，95%CI（0.27，9.11），P=0.61]、部分缓解率[RR=0.86，95%CI（0.68，1.09），P=0.20]、总有效率[RR=0.88，95%CI（0.71，1.09），P=0.26]上表现出与5-FU/LV+伊立替康相似的效果，安全性方面卡培他滨+伊立替康有较高的Ⅲ/Ⅳ级恶心[RR=1.92，95%CI（1.05，3.54），P=0.04]、腹泻[RR=3.23，95%CI（2.14，4.89），P＜0.000 01]发生风险和较低的Ⅲ/Ⅳ级中性粒细胞减少[RR=0.72，95%CI（0.53，0.98），P=0.04]发生风险。 结论 根据当前现有证据，5-FU/LV+伊立替康可能较卡培他滨+伊立替康更为有利于转移性结直肠癌患者的治疗，但仍需结合临床实际情况进行化疗方案的优选。
目的:比较常规放射治疗与放射治疗同期合并顺铂(PDD)加卡培他滨(CAP)治疗局部晚期鼻咽癌的有效性,同时评价此联合方式的安全性。方法:从2003年2月至2005年11月,78例局部晚期鼻咽癌患者(Ⅲ、Ⅳa,92分期)随机分为两组,放化疗组在放疗的第1、4、7周均用PDD+CAP各化疗一周期,PDD:20mg/m2,静脉滴注,连用5天;CAP:1000mg/m2,每天2次,连用14天,休7天;21天为一周期。两组放疗方法相同:鼻咽原发灶采用60Co外照射,颈部淋巴结引流区采用60Co前切线照射加深部X线垂直照射,鼻咽部剂量为65～70 Gy／6.5～7周,颈淋巴结转移灶剂量为65～70 Gy／6.5～7周。结果:放化疗组及单放组治疗结束后3个月鼻咽部肿瘤完全消退率分别为89.7%,69.2%(P﹤0.05)。3年生存率分别为76.9%,53.8%(P﹤0.05)。结论:顺铂加卡培他滨方案联合放化疗治疗局部晚期鼻咽癌可改善患者的生存,毒副反应可耐受。
ObjectiveTo assess the effectiveness and safety of capacitance combined with irinotecan (CAPIRI) versus fluorouracil combined with irinotecan (FOLFIRI) for patients with advanced metastatic colorectal cancer. MethodsDatabases such as Pubmed, Embase, Wanfang data, CNKI, Cochran Library were searched from January 2000 to October 2015. We evaluated the quality of randomized controlled trials (RCTs) and then extracted data from them. RevMan 5.2 software was used to perform the meta-analysis. ResultsEight RCTs studies with 1 634 advanced metastatic colorectal cancer patients were included based on our standard. CAPIRI regimen was equal to FOLFIRI regimen in complete response rate [RR=1.17, 95%CI (0.70, 1.96), P=0.56], overall respond rate [RR=0.90, 95%CI (0.79, 1.03), P=0.12], disease control rate [RR=0.93, 95%CI (0.87, 1.00), P=0.06], median progression-free survival [HR=1.00, 95%CI (0.72, 1.37), P=0.99], and median overall survival [HR=0.94, 95%CI (0.63, 1.40), P=0.77]. For safety, higher incidence rate of grade 3/4 vomiting [RR=1.91, 95%CI (1.13, 3.22), P=0.02], diarrhea [RR=2.84, 95%CI (2.22, 3.63), P<0.000 01], hand-foot syndrome [RR=4.55, 95%CI (2.15, 9.61), P<0.000 1] were confirmed for CAPIRI. The two methods had similar toxicities: nausea [RR=0.77, 95%CI (0.64, 0.93), P=0.005], fatigue [RR=1.19, 95%CI (0.73, 1.94), P=0.47], febrile neutropenia [RR=1.59, 95%CI (0.89, 2.87), P=0.12], anemia [RR=1.74, 95%CI (0.59, 5.18), P=0.32], and leukopenia [RR=0.77, 95%CI (0.64, 0.93), P=0.005]. ConclusionCapecitabine combined with irinotecan treatment for advanced colorectal cancer is effective and its toxicity is acceptable.
ObjectiveTo investigate the curative effects of capecitabine and hessaitin combined with whole brain radiotherapy for treatment the HER2 positive breast cancer with brain metastasis. MethodsThe clinical data of 60 cases HER2-positive breast cancer patients with brain metastasis in our hospital in January 2004 to January 2012 were retrospectively analyzed.The 32 cases of observe group were treated by using capecitabine and herceptin combined with whole brain radiotherapy, and the 28 cases of control group were treated by using capecitabine and cisplatin combined with whole brain radiotherapy.The disease control rate, toxicity rate, and survival rate were evaluated. ResultsCompared with the control group, the disease control rate, toxicity rate, and survival rate were all better in observe group (P < 0.05). ConclusionThe capecitabine and hessaitin combined with whole brain radiotherapy for treating patients with HER 2 positive brest cancer transferred to brain are effect and safe.
Objective To investigate the efficacy of Docetaxel injection and Capecitabine tablets combined with Oxaliplatin injection in chemotherapy for patients after esophageal cancer surgery. Methods We retrospectively analyzed the clinical data of 101 patients with esophageal cancer who underwent radical surgery from June 2010 to December 2012, including 58 males and 43 females. According to the different treatment methods they were divided into a study group (58 patients, 32 males and 26 females, postoperatively receiving Docetaxel injection, Capecitabine tablets, Oxaliplatin injection and chemotherapy) and a control group (43 patients, 26 males and 17 females, taking Docetaxel injection and Capecitabine tablets for 4 consecutive courses). We compared the difference in the outcomes between the two groups. Results There was no significant difference in the level of serum anticancer antigen (CEA), carbohydrate antigen 125 (CA125), carbohydrate antigen 199 (CA199) and squamous cell carcinoma antigen (SCC) before chemotherapy between two groups (P>0.05). After chemotherapy, the level of serum CEA, CA125, CA199, SCC in the study group was significantly lower than that in the control group (P<0.05). The 1-year survival rate of the study group was 92.59% and the 2-year survival rate was 70.37%, which were not significantly different from those of the control group (P>0.05). The 3-year survival rate of the study group was significantly higher than that of the control group (57.41 %vs. 32.43%, P<0.05). The mean survival time of the study group was longer than that of the control group (31 monthsvs. 22 months, P=0.001). Conclusion Docetaxel injection and Capecitabine tablets combined with Oxaliplatin injection for the treatment of esophageal cancer surgery can significantly reduce levels of tumor markers in serum after esophageal cancer surgery, and is favorable for the long-term survival of patients, but adverse reactions should be noted.