替吉奥联合胰十二指肠切除术治疗胰腺癌88例临床疗效观察

目的 研究替吉奥联合胰十二指肠切除术治疗胰腺癌的临床效果,为胰腺癌的治疗提供更多的选择.方法 对2009年2月-2015年1月在南京医科大学附属南京医院肝胆外科入院治疗的176例胰腺癌患者的病例资料进行了研究,数值随机化法分为观察组和对照组,每组各88例,两组患者均首先采用胰十二指肠切除术进行手术切除治疗,然后给予后续治疗方案,其中对照组给予吉西他滨进行治疗,观察组患者给予替吉奥进行治疗,两组方案均以3周为一个治疗周期,于2个治疗周期后比较两组治疗方案的总有效率,两组患者的临床受益反应情况、两组患者治疗后的生存情况,以及两组治疗方案的不良反应,并比较两组患者的生活质量.结果采用t检验或者x2检验.结果 观察组患者临床受益反应率明显高于对照组,两组比较差异有统计学意义(P＜0.05);观察组临床总有效率为90.9％,对照组临床总有效率为61.4％,差异有统计学意义(P＜0.05);观察组患者平均生存期为(33.7 ±7.7)个月,对照组平均生存期为(21.4±5.6)个月,并且观察组患者2年及3年的生存率均高于对照组,差异有统计学意义(P＜0.05);两组患者不良反应以血液学和消化道反应为主,其中观察组患者恶心和呕吐、白细胞减少和消化道溃疡发病率明显低于对照组,差异有统计学意义(P＜0.05);观察组患者化疗后4 ～12周的生活质量评分明显高于同期对照组生活质量评分,两组比较差异明显,差异有统计学意义(P＜0.05).结论 替吉奥联合胰十二指肠切除术治疗胰腺癌临床效果显著,可以显著延长患者的生存时间、降低不良反应,患者临床受益率和临床总有效率更高,且可以改善患者的生活质量,优于吉西他滨联合治疗方案,值得临床推广应用.

Clinical effect of tegafur and pancreatoduodenectomy on treatment of 88 pancreatic cancer

Objective To investigated the clinical effect of Tegafur and pancreatoduodenectomy (PD) on treatment of pancreatic cancer.Methods A total of 176 patients from Fed.2009 to Jan.2015 were enrolled in the study,they were numerical randomly devided into two groups,the control group and observation group,88 patients for each group.Both of the two groups were treatment with the pancreatoduodenectomy,the control was treated with Gemcitabine together,the observation group was treated with Tegafur.The treatment period were 3 weeks,the total clinical effect,the clinical benefit response,the survial,the adverse effect and the life quality were compared between the two groups.The result was analysed by t-test or x2-test.Results The clinical benefit response in the observation group was significantly higher than control (P ＜ 0.05),the clinical effect in the observation group was 90.9％,which was higher than control (61.4％).The mean survival time in the observation group was (33.7 ± 7.7)month,the control was (21.4 ± 5.6)month,the survival rate in 2 and 3 years of observation group was higher than control(P ＜ 0.05);the main adverse effect in the two group was hematology and digestive tract reaction,the rate of nausea aad vomiting、leukopenia and ulcer of observation group was lower than control group.The life quality score in 4 to 12 weeks after chemotherapy was significantly higher than control (P ＜ 0.05).Conclusion The clinical effect of Tegafur and pancreatoduodenectomy on treatment of pancreatic cancer was obviously,which survival time was significant extended,the adverse reactions was reduced,the clinical benefit response rate,total clinical effect rate and atient's quality of life was improved,it was better than gemcitabine combined treatment,it was worthy of clinical popularization and application.