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目的观察吉西他滨联合替吉奥对多西他赛治疗失败的转移性去势抵抗性前列腺癌(metastatic castrate-resistant prostate cancer,m CRPC)的近期疗效和毒副作用。方法选取2013年7月—2015年12月在四川大学华西医院经多西他赛治疗失败的16例m CRPC患者为研究对象,治疗方法均相同,具体化学疗法(化疗)方案为:吉西他滨1 000 mg/m2,静脉滴注,第1天;替吉奥40~60 mg/m2,口服,2次/d,第1~10天;14 d为1个疗程。主要观察指标为血清总前列腺特异性抗原(total prostate specific antigen,T-PSA)下降率及疼痛缓解率,并对不良反应进行统计。结果 13例可评价疗效的患者中有4例T-PSA下降≥50%,有效率为30.8%;11例骨痛患者中有4例明显缓解,癌痛缓解率为36.4%。化疗的不良反应包括骨髓抑制、胃肠道反应、皮疹及疲乏等,均在可耐受的范围。结论吉西他滨联合替吉奥化疗方案对多西他赛治疗失败后的m CRPC患者有一定的临床疗效,毒副作用可耐受。
Objective To observe the short-term curative effect and toxicity of gemcitabine combined with tirgil on patients with metastatic castrate-resistant prostate cancer (mCRPC) that failed docetaxel treatment. Methods Sixteen patients with mCRCR who failed docetaxel treatment at West China Hospital of Sichuan University from July 2013 to December 2015 were enrolled in this study. The treatment methods were the same. The specific chemotherapy (chemotherapy) regimen was gemcitabine 1 000 mg / m2, intravenous infusion, on the first day; for Gio 40 ~ 60 mg / m2, orally, 2 times / d, 1 to 10 days; 14 d for a course of treatment. MAIN OUTCOME MEASURES: Descending rate and pain relief rate of total prostate specific antigen (T-PSA) in serum and statistics of adverse reactions. Results T-PSA in 4 of 13 evaluable patients decreased by 50% or more, with an effective rate of 30.8%. Out of 11 patients with bone pain, 4 were relieved and the pain relief rate was 36.4%. Adverse reactions to chemotherapy include myelosuppression, gastrointestinal reactions, rash and fatigue, all within tolerable range. Conclusions Gemcitabine combined with tiagoglio regimen has certain curative effect on patients with mCRPC after the failure of docetaxel treatment. Toxic and side effects can be tolerated.