论文部分内容阅读
Objective:Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world and the third leading cause of cancer related death globally.Parentral treatment of Egyptian patients of bilharziasis contributed to the high incidence of viral hepatitis,and subsequently liver cirrhosis and HCC.Capecitabine plus cisplatin protocol was evaluated regarding the efficacy and safety in patients with advanced HCC as first line chemotherapy.Methods:One hundred patients with advanced HCC were randomized to receive either capecitabine (1000 mg/m 2) twice daily for fourteen days plus intravenous cisplatin (60 mg/m 2) on day one to be repeated every three weeks with a maximum of six cycles or placebo (phase III trial).Results:Baseline characteristics were comparable in both groups.According to Barcelona Clinic Liver Cancer Staging System,stage C was the most predominant (82% vs.75%) in both groups.Median OS was 12 months versus 10 months in favor of the treated group (P value < 0.05).Median TTP was significantly higher in the chemotherapy group (7 months vs.4.5 months) as well as disease control rate (40% vs.29%),no patient had achieved complete response.Grade 3 toxicity was more pronounced in the treatment group,as regards vomiting and diarrhea (10% vs.2%),neurotoxicity (6% vs.2%),elevation of aminotransferase and bilirubin (9.8% vs.4.9%),hand and foot syndrome reaction was recorded only in chemotherapy group.Conclusion:Capecitabine plus cisplatin regimen showed modest antitumor activity with tolerable toxicity in patients with advanced HCC.Moreover,because of the significantly prolonged time to progression,we demand further attention to this convenient,outpatient,and economic profile based chemotherapy protocol.
Objective: Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world and the third leading cause of cancer related death globally. Parentral treatment of Egyptian patients of bilharziasis contributed to the high incidence of viral hepatitis, and subsequently liver cirrhosis and HCC. Capecitabine plus cisplatin protocol was evaluated regarding the efficacy and safety in patients with advanced HCC as first line chemotherapy. Methods: One hundred patients with advanced HCC were randomized to either either capecitabine (1000 mg / m2) twice daily for fourteen days plus intravenous cisplatin (60 mg / m 2) on day one to be repeated every three weeks with a maximum of six cycles or placebo (phase III trial). Results: Baseline characteristics were comparable in both groups. According to Barcelona Clinic Liver Cancer Staging System, stage C was the most predominant (82% vs. 75%) in both groups. Median OS was 12 months versus 10 months in favor of the treated group (P value <0.05) .Median TTP was significantly higher in the chemotherapy group (7 months vs.4.5 months) as well as disease control rate (40% vs.29%), no patient had achieved complete response.Grade 3 toxicity was more pronounced in the treatment group, as regards Elevation of aminotransferase and bilirubin (9.8% vs 4.9%), hand and foot syndrome reaction was recorded only in the chemotherapy group. Confusion: Vomiting and diarrhea (10% vs 2% Capecitabine plus cisplatin regimen showed modest antitumor activity with tolerable toxicity in patients with advanced HCC. Moreover, because of the significantly prolonged time to progression, we further further attention to this convenient, outpatient, and economic profile based chemotherapy protocol.