《胃癌方案比较》课件.pptVIP

希罗达－胃癌治疗策略 胃癌术后辅助治疗：X/XELOX 晚期胃癌一线治疗：X / XP / XELOX / XPa 晚期胃癌一线治疗后的维持治疗：X 希罗达?联合方案治疗胃癌 希罗达? 顺铂 （XP） （XEC） 奥沙利铂 （XO） （XEO） 紫杉醇 （XT） 多西紫杉醇 （XD） 铂类 紫杉类 希罗达在胃癌治疗中的患者选择 胃癌辅助治疗： 单药：针对老年及不能耐受强力化疗的患者均可采用希罗达单药治疗 联合： 希罗达首先选择联合铂类的治疗方案（包括顺铂及奥沙利铂） 如果患者存在神经系统病变，则选择联合紫杉类进行辅助治疗 希罗达在胃癌一线治疗中的患者选择 单药： 针对老年及不能耐受强力化疗的患者均可采用希罗达单药治疗 联合： 如果辅助治疗中未曾使用铂类药物，希罗达首先选择联合铂类的治疗方案（包括顺铂及奥沙利铂） 如果辅助治疗采用过铂类药物，则选择联合紫杉类进行一线治疗 如果患者存在神经系统病变，则选择联合紫杉类进行辅助治疗 如果患者骨髓抑制相对严重，则考虑选择铂类治疗 一线治疗后的维持治疗：希罗达单药 * ML17032 trial design – An open label, randomized, international multi-center Phase III study of Xeloda in combination with cisplatin versus 5-FU/cisplatin. The doses evaluated were: Cisplatin: 80mg/m2 3- hour i.v. infusion on d1 with hyperhydration Xeloda: 1 000mg/m2 daily; d1-14 q3 weeks 5-FU: 800mg/m2/day; d1-5 q3 weeks. A total of 316 patients were enrolled: 160 randomized to Xeloda/cisplatin and 156 randomized to 5-FU/cisplatin. The target population was typical for a first-line trial with creatinine clearance 60mL/min and measurable disease according to RECIST criteria. Primary objective: confirm non-inferiority in progression-free survival (PFS) between the two treatment arms. * Xeloda/cisplatin and 5?FU/cisplatin were similar in terms of the percentage of patients experiencing hematologic adverse events (all grades) during the trial. These data represent changes from baseline values. Neutropenia was the most frequently reported hematotoxicity occurring in 33% of patients on Xeloda/cisplatin vs. 30% of patients on 5-FU/cisplatin. Anemia occurred more frequently on Xeloda/cisplatin in comparison to 5-FU/cisplatin. Leukopenia was more frequent in the FP arm vs. XP. * 有全文 Phase II study of capecitabine plus cisplatin as first-line chemotherapy in advanced gastric cancer.Kim TW, Kang YK, Ahn JH, Chang HM, Yook JH, Oh ST, Kim BS, Lee JS.Section of Hematology-Oncology, Department of Medicine and Department of General Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.BA