吉西他滨联合顺铂或氟尿嘧啶治疗晚期胰腺癌临床疗效比较

目的:观察吉西他滨联合顺铂(GP方案)与吉西他滨联合氟尿嘧啶(GF方案)治疗晚期胰腺癌近期疗效和毒副作用的差异。方法:经病理组织学或细胞学证实的60例胰腺癌患者,按照随机对照的原则分为GP组和GF组,各30例。GP组给予吉西他滨1000mg/m~2加生理盐水100ml,静脉滴注30min,第1、8、15天;顺铂40mg,静脉点滴,第15、16、17天。GF组给予吉西他滨1000mg/m~2加生理盐水100ml,静脉滴注30min,第1、8、15天,氟尿嘧啶500mg/m~2加5％葡萄糖液(GS)500ml,静脉点滴6h以上,第1～5天。结果:GP组部分缓解(PR)3例,微效(MR)5例,稳定(NC)12例,进展(PD)5例,PR+MR达32.0％,中位生存期8.7个月,临床受益率(CBR)57.7％,肿瘤标志物CA19-9下降>50％为48.1％。GF组PR3例,MR8例,NC9例,PD4例,PR+MR达45.8％,中位生存期10.1个月,CBR82.1％,CA19-9下降>50％为53.6％。两组经统计学比较,CBR差异有显著性(P<0.05)。主要毒性反应为白细胞减少和血小板减少。结论:吉西他滨联合氟尿嘧啶以及吉西他滨联合顺铂,较以往单药方案疗效高,副作用少,中位生存期长,CBR高;GP方案和GF方案比较,后者的CBR更高。

A Comparative Study of Gemcitabine plus Cisplatin and Gemcitabine plus Fluorouracil in Treating of Advanced Pancreatic Cancer

Objective:To compare the efficacy and toxicity of Gemcitabine plus Cisplarin and Gemcitabine plus Huorouracil in treating advanced pancreatic cancer. Methods: Sixty patients with advanced pancreatic cancer were randomly divided into group GP(30 cases) and group GF(30 cases). All patients were treated with Gemcitabine in dose of 1 000 mg/m2(diluted in 100 ml saline solution over 30 minutes)once a week for 3 consecutive weeks every 4 weeks.Group GP was followed by Cis-platin 40mg,intravenous drip on day 15,16,17. Group GF was followed by 5-FU 500 mg/m2(diluted in 5%GS 500 ml.ivd, over 6 hours), on day 1-5. Results:In group GP, 8 cases (32.0%) were PR and MR,the media survival time was 8.7 months,Clinical Beneficial Rate(CBR) was 57.7%, and A decrease (over 50%) of CA19-9 was observed 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 a decrease (over 50%) of CA19-9 was observed in 15 cases (53.6%). There was a significant difference on CBR between the two groups (P<0.05). The main toxicities had leukopenia and thrornbocytopenia. Conclusion: GP or GF is a feasible and well-tolerated scheme in treating advanced pancreatic cancer. It has a better therapeutic efficacy with low adverse reaction,long median survival period and high CBR, especially in GF scheme.