摘要
目的探讨中药汤剂辨证施治联合生长抑素类似物(SSA)治疗晚期胃肠胰腺神经内分泌肿瘤(GEP-NET)的疗效及安全性。方法收集2011年9月至2015年8月于中日友好医院中西医结合肿瘤内科就诊的晚期GEP-NET患者39例,原发部位分别为胰腺19例、直肠8例、小肠8例、胃1例和原发灶不明的肝转移性神经内分泌肿瘤3例,均给予中药汤剂联合SSA治疗,具体治疗方案:注射用醋酸奥曲肽微球(善龙)20 mg,肌肉注射,3~4周1次或注射用醋酸兰瑞肽(索马杜林)40 mg,肌肉注射,10~14天1次;同时根据患者情况予中药辩证施治,每日1剂,早晚分服。每3个月采用RECIST 1.1标准评估疗效,采用NCI-CTC 3.0标准观察和判定不良反应。根据随访资料记录疾病进展时间(TTP)并动态监测血清嗜铬粒蛋白A(Cg A)的变化。结果全组39例患者均可评价疗效,其中20例获疾病进展,19例获稳定,有效率为0,疾病控制率为48.7%,中位TTP为22.9个月。主要不良反应包括胆结石和1~2级腹泻。结论中药汤剂辨证施治联合SSA治疗可能延长晚期GEP-NET患者的TTP,不良反应轻,值得在临床上观察使用。
Objective To explore the efficacy and safety of traditional Chinese medicine （TCM） in combination with soma- tostatin analogues （SSA） therapy for advanced gastroenteropanereatic neuroendocrine tumors （GEP-NET）. Methods From September 20l 1 to August 2015, 39 patients with advanced GEP-NET who were treated in the Department of Integrative Oncology, China-Japan Friendship Hospital were enrolled in this study. Among 39 GEP-NET, 19 were localized in pancreas, 8 cases in rectum, 8 cases in small intestine, 1 case in stomach and 3 cases of primary unknown. All the patients received TCM plus SSA therapy. SSA was given as octreotide LAR （20rag, ira, every 3-4 weeks） or Lanreotide （40 rag, ira, every 10-14 days）. At the same time, patients were treated with Chinese herb decoction according to syndrome differentiation. Efficacy was evaluated using RECIST 1.1 criteria every 3 months. Adverse events were evaluated according to NCI-CTC 3.0. The time to progression （TTP） was observed. Serum chromogranin A （CgA） was also monitored according to the schedule. Results A total of 39 cases were evaluated for efficacy including 20 cases of disease progression and 19 eases of stable disease with the objective response rate of 0 and disease control rate of 48.7%. The median TFP was 22. 9 months. The main adverse events were cholelithiasis and 1 to 2 grade diarrhea. Conclusion TCM in combination with SSA treatment may significantly prolong the TTP for advanced GEP-NET with mild adverse effects, be worthy of further clinical application widely.（TCM） ; Chromogranin A （CgA）
出处
《临床肿瘤学杂志》
CAS
2017年第3期238-242,共5页
Chinese Clinical Oncology
关键词
胃肠胰腺神经内分泌肿瘤
生长抑素类似物
中药
嗜铬粒蛋白A
Gastroenteropancreatic neuroendocrine tumors （GEP-NET）
Somatostatin analogue （SSA）
Traditional Chinese medicine
