CAJ | 학술논문

背景与目的：化疗是晚期小肠腺癌的主要治疗手段，目前尚无标准治疗方案。本研究旨在评估替吉奥联合奥沙利铂治疗晚期小肠腺癌的疗效与安全性。方法：收集29例经替吉奥联合奥沙利铂治疗的晚期小肠腺癌患者的临床资料，并进行回顾性分析。化疗方案：第1天，静脉滴注奥沙利铂130 mg/m2；第1~14天，口服替吉奥40 mg/m2，每日2次，21 d为1个周期。结果：患者完成中位化疗周期数4(2~9)个，均可评估疗效，其中完全缓解(complete response，CR)2例(6.9%)，部分缓解(partial response，PR)9例(31.0%)，客观有效率(response rate，RR)为37.9%，疾病控制率(disease control rate，DCR)为65.5%。无一例患者失访，中位随访时间为14.7个月。患者中位无进展生存时间(progress free survival，PFS)为5.4个月(95%CI：3.6~7.2)，中位总生存时间(overall survival，OS)为13.2个月(95%CI：6.7~19.7)。亚组分析显示，替吉奥联合奥沙利铂方案非一线化疗、体力状况(Eastern Cooperative Oncology Group，ECOG)评分>1分，转移部位>2个的患者中位OS明显缩短(P<0.05)。化疗的主要不良反应为骨髓抑制、胃肠道反应、乏力、周围神经病变和皮疹，以轻度为主，均可耐受。结论：本研究，结果显示，替吉奥联合奥沙利铂治疗晚期小肠腺癌有效率高、耐受性好，值得进一步研究。
배경여목적：화료시만기소장선암적주요치료수단，목전상무표준치료방안。본연구지재평고체길오연합오사리박치료만기소장선암적료효여안전성。방법：수집29례경체길오연합오사리박치료적만기소장선암환자적림상자료，병진행회고성분석。화료방안：제1천，정맥적주오사리박130 mg/m2；제1~14천，구복체길오40 mg/m2，매일2차，21 d위1개주기。결과：환자완성중위화료주기수4(2~9)개，균가평고료효，기중완전완해(complete response，CR)2례(6.9%)，부분완해(partial response，PR)9례(31.0%)，객관유효솔(response rate，RR)위37.9%，질병공제솔(disease control rate，DCR)위65.5%。무일례환자실방，중위수방시간위14.7개월。환자중위무진전생존시간(progress free survival，PFS)위5.4개월(95%CI：3.6~7.2)，중위총생존시간(overall survival，OS)위13.2개월(95%CI：6.7~19.7)。아조분석현시，체길오연합오사리박방안비일선화료、체력상황(Eastern Cooperative Oncology Group，ECOG)평분>1분，전이부위>2개적환자중위OS명현축단(P<0.05)。화료적주요불량반응위골수억제、위장도반응、핍력、주위신경병변화피진，이경도위주，균가내수。결론：본연구，결과현시，체길오연합오사리박치료만기소장선암유효솔고、내수성호，치득진일보연구。
Background and purpose: Small bowel adenocarcinoma (SBA) is uncommon, and frequently diagnosed at late stage. Chemotherapy is the main treatment method for advanced SBA. Despite recent progress in SBA therapy, no standard regimen has been established up to now, and new active regimen is expected to improve the outcome of this disease. The purpose of this study was to evaluate the efifcacy and safety of S-1/oxaliplatin for the treatment of advanced SBA. Methods:In a retrospective study, clinical characteristics and outcomes of 29 patients with advanced SBA were collected and analyzed. Patients received oral S-1 40 mg/m2, twice daily, d1-14, oxaliplatin was administered intravenously 130 mg/m2 on the ifrst day of every cycle, repeated every 3 weeks. Efifcacy and toxicity were evaluated after at least two consecutive cycles. Results:All patients were evaluated for efifcacy and safety. The objective response and disease control rates were 37.9%and 65.5%, respectively. The median progression-free survival and overall survival were 5.4 months (95%CI:3.6-7.2) and 13.2 months (95%CI:6.7-19.7), respectively. In univariate analysis, the following factors were signiifcantly associated with poor outcome:not ifrst line chemotherapy setting, ECOG performance status>1 and sites of metastasis>2 (Log-rank, P<0.05). The treatment related adverse events were mild and manageable. Myelosuppression, gastrointestinal reaction, fatigue, sensory neuropathy and rash were the most common toxicities. Conclusion:This study was the ifrst to report the efifcacy of S-1 combined with oxaliplatin for advanced SBA. S-1/oxaliplatin may be effective and safe for advanced SBA and worthy of further study.