吉西他滨联合顺铂或氟尿嘧啶治疗晚期胰腺癌临床疗效的比较

目的　比较GP方案 (吉西他滨 顺铂 )与GF方案 (吉西他滨 氟尿嘧啶 )治疗晚期胰腺癌的近期疗效和毒副作用。方法　经病理组织学或细胞学检查证实的 60例胰腺癌患者 ,随机分为GP组和GF组 ,各 3 0例。GP组给予吉西他滨 10 0 0mg/m2加生理盐水 10 0ml,静脉滴注 3 0min ,第 1、8、15天 ;顺铂 40mg ,静脉滴注 ,第 15、16、17天。GF组给予吉西他滨 10 0 0mg/m2 加生理盐水 10 0ml ,静脉点滴 3 0min ,第 1、8、15天 ;氟尿嘧啶 5 0 0mg/m2 加 5 %GS 5 0 0ml ,静脉滴注时间超过 6h ,第 1～ 5天。结果　GP组PR 3例 ,MR 5例 ,NC 12例 ,PD 5例 ,PR MR为 3 2 .0 % ,中位生存期为 8.7个月 ,临床受益反应率 (CBR )为 5 7.7% (15 /2 6) ,CA 19 9水平下降超过 5 0 %者达 48.1% (13 /2 7)。GF组PR 3例 ,MR 8例 ,NC 9例 ,PD 4例 ,PR MR为 45 .8% ,中位生存期为 10 .1个月 ,CBR 82 .1% (2 3 /2 8) ,CA19 9水平下降超过 5 0 %者达 5 3 .6% (15 /2 8)。 2组比较 ,CBR有显著性差异 (P <0 .0 5 ) ,GF疗效较佳。不良反应主要为白细胞减少和血小板减少 ,2组无显著性差异。结论　含吉西他滨的联合化疗方案与以往单药方案比较 ,疗效高、副作用小、患者中位生存期长 ,临床受益反应率 (CBR )高 ;GP方案和GF方案比较 ,后者CBR更高 (5

Comparative Study of Gemcitabine Plus Cisplatin and Gemcitabine Plus Fluorouracii in the Treatment of Advanced Pancreatic Cancer

Objective To compare the efficacy and toxicity of Gemcitabine plus Cisplatin and Gemcitabine plus Fluorouracil in the treatment of advanced pancreatic cancer.Methods Sixty patients with advanced pancreatic cancer were randomly divided into GP group(Gemcitabine Cisplatin,30 cases) and GF group(Gemcitabine Fluorouracil,30 cases).All patients were treated with Gemcitabine in dose of 1 000 mg/m 2(diluted in 100 ml saline solution over 30 minutes) once a week for 3 consecutive weeks.Group GP was followed by Cisplatin 40 mg,intravenous drip on day 15,16,17.Group GF was followed by 5-Fu 500 mg/m 2(diluted in 5%GS 500 ml,ivd,over 6 hours) every day for the first five days.Results In group GP,8 cases(32.0%) were PR and MR,the median survival time was 8.7 months,Clinical Beneficial Rate(CBR) was 57.7%,and CA19-9 decreased by over 50% in 13 cases(48.1%).In group GF,11 cases(45.8%) were PR and MR,the media survival times was 10.1 months,CBR was 82.1%,and CA19-9 decreased by over 50% in 15 cases(53.6%).There was significant difference in CBR between the two groups(P<0.05).The main toxicities were leukopenia and thrombocytopenia.Conclusion GP or GF is a feasible and well-tolerated cheomtherapy regimen in treating of advanced pancreatic cancer with a better therapeutic efficacy and few side effect.The median survival period is long and CBR is high,especially with GF regimen.