晚期十二指肠癌化疗的方案和疗效比较

  目的  通过回顾性分析晚期原发十二指肠癌的化疗疗效，探索十二指肠癌的有效化疗方案。  方法  选取2002年1月至2012年12月北京朝阳区三环肿瘤医院收治的晚期原发十二指肠癌患者56例，分析化疗的有效率、疾病控制率，对无进展生存及总生存率的影响。  结果  化疗总有效率19.04%，疾病控制率71.42%，其中氟尿嘧啶联合奥沙利铂方案（FOLFOX）有效率高于其他方案（35.29% vs. 7.69%，P=0.011）；同未化疗患者相比，化疗延长晚期原发十二指肠癌患者的生存时间（13.35个月vs. 5.65个月，HR=0.20，95%CI:0.083~0.497，P=0.000 5）；以氟尿嘧啶类为基础的化疗方案优于其他化疗方案，可延长无进展生存（5.08个月vs. 1.08个月，HR=0.004，95%CI:0.000~0.315，P=0.013 2）。多因素分析表明，淋巴结转移及病理检测存在黏液腺癌组织是十二指肠癌的独立预后因素。  结论  姑息性化疗可能提高晚期十二指肠癌患者的总生存率。 

Chemotherapy and comparison of agents for advanced duodenal carcinoma

  Objective  This study aims to determine the efficacy of chemotherapy and to identify potential chemotherapy agents for advanced primary duodenal carcinoma (PDC).  Methods  Fifty-six patients with advanced PDC, who did and did not receive chemotherapy, were involved in this study. Response rates (RR), disease control rates (DCR), progression-free survival (PFS), and overall survival (OS) were analyzed.  Results  The overall RR and DCR of 43 patients were 19.04% and 71.42%, respectively. The patients who received chemotherapy agents fluorourzcil and oxaliplatin exhibited higher RR compared with patients who received other chemotherapy combinations (35.29% vs. 7.69%, P=0.010 9). Palliative chemotherapy improved the OS of patients with advanced PDC compared with patients who did not receive chemotherapy (13.35 months vs. 5.65 months, HR=0.203, 95% CI: 0.083 to 0.497, P=0.000 5). Compared with the use of other chemotherapy regimens, treatment with a fluorourzcil-based chemotherapy agent resulted in a longer PFS (5.08 months vs. 1.08 months, HR=0.004, 95% CI:0.000 to 0.315, P=0.013 2). Multivariate analysis indicated mucinous histology and lymph mode metastasis as factors predictive of poor prognosis in patients with advanced PDC.  Conclusion  Palliative chemotherapy may improve the OS of patients with advanced PDC.