吉西他滨联合替吉奥胶囊治疗晚期胰腺癌的疗效观察

目的探讨吉西他滨联合替吉奥胶囊化疗方案与吉西他滨单药治疗进展期胰腺癌的疗效。方法对2008年1月至2011年1月收治的52例晚期胰腺癌患者的临床资料进行回顾性分析,其中28例采用吉西他滨联合替吉奥胶囊方案治疗(A组);24例采用吉西他滨单药治疗(B组)。采用Kaplan-Meier法分析患者的生存时间,并比较两组患者的客观缓解率、临床受益反应(CBR)、中位疾病进展时间、中位生存时间和不良反应。结果 A组有效率明显高于B组(32.1%vs.20.8%),差异有统计学意义(P=0.039)。A组疾病控制率(DCR)高于B组(67.9%vs.45.8%),但差异无统计学意义(P=0.230)。A组患者CBR缓解率高于B组(72.1%vs.46.9%),差异无统计学意义(P=0.41)。A组的中位生存时间为10.2个月(95%CI:8.0～11.8个月),高于B组的8.03个月(95%CI:3.8～10.9个月),差异有统计学意义(P=0.045);A、B两组的中位疾病进展时间分别为3.6个月和3.0个月(P=0.721)。A组的6个月生存率(72.7%)略高于B组(66.8%),但差异无统计学意义(P>0.05)。两组不良反应的发生率也相似(P>0.05)。结论吉西他滨联合替吉奥胶囊治疗方案与单药治疗晚期胰腺癌相比,在客观疗效、中位生存时间表现出一定优势,疾病控制率及临床受益反应也有所提高,且不良反应可耐受,是晚期胰腺癌的有效治疗方案。     

吉西他滨联合顺铂与单药吉西他滨治疗晚期胰腺癌的疗效比较

目的比较吉西他滨联合顺铂与单药吉西他滨治疗晚期胰腺癌的疗效。方法将53例局部晚期或转移性胰腺癌患者随机分两组,27例采用吉西他滨联合顺铂化疗(联合组),26例单纯应用吉西他滨化疗(单药组),对其疗效及毒副反应进行观察。结果可评估病例51例。联合组和单药组有效率分别为15.4%和12.0%(χ2=0.0031,P=0.9555),临床获益率(CR PR SD)分别为76.9%和44.0%(χ2=5.7955,P=0.0161);6个月生存率分别为73.1%和48.0%(χ2=3.3623,P=0.0667);CA199降低率分别为55.6%和47.6%(χ2=0.2444,P=0.6211);Ⅲ～Ⅳ度血液学毒性发生率分别为14.8%和11.5%(χ2=0.0029,P=0.9573)。结论吉西他滨联合顺铂与单药吉西他滨治疗晚期胰腺癌安全有效,前者在临床获益方面优于后者,在延长生存期方面也显示出一定的优势,但该差异未达到有显著性;在严重血液学毒性反应和降低CA199方面,二者差异无显著性。     

奥沙利铂联合卡培他滨治疗晚期胃癌的临床观察

目的：探讨奥沙利铂联合卡培他滨治疗晚期胃癌近期疗效。方法：82例晚期胃癌患者随机分为两组,A组采用奥沙利铂＋卡培他滨方案化疗,B组采用顺铂＋5～氟尿嘧啶＋甲酰四氢叶酸化疗,观察其有效率及不良反应。结果：A组有效率为54．55％,B组有效率为28．95％,P〈0．05,两者有显著性差异。且A组的胃肠道反应明显减轻。其他相关不良反应能耐受。结论：奥沙利铂联合卡培他滨方案治疗晚期胃癌疗效较好,不良反应能够耐受,可在晚期胃癌病人中应用。     

奥沙利铂联合卡培他滨治疗晚期胃癌的临床观察

目的:探讨奥沙利铂联合卡培他滨治疗晚期胃癌近期疗效.方法:82例晚期胃癌患者随机分为两组,A组采用奥沙利铂+卡培他滨方案化疗,B组采用顺铂+5-氟尿嘧啶+甲酰四氢叶酸化疗,观察其有效率及不良反应.结果: A组有效率为54.55%,B组有效率为28.95%,P<0.05,两者有显著性差异.且A组的胃肠道反应明显减轻.其他相关不良反应能耐受.结论:奥沙利铂联合卡培他滨方案治疗晚期胃癌疗效较好,不良反应能够耐受,可在晚期胃癌病人中应用.     

国产吉西他滨联合5-氟尿嘧啶治疗晚期胰腺癌临床观察

目的:观察国产吉西他滨联合5-氟尿嘧啶治疗晚期胰腺癌临床疗效及不良反应.方法:19例晚期胰腺癌患者随机分为两组,观察组10例,给予GCF方案(吉西他滨联合5-氟尿嘧啶),21天为1周期;对照组9例,给予FAM方案(5-氟尿嘧啶联合阿霉素、丝裂霉素),21天为1周期,均至少化疗2周期.结果:19例患者均可评价疗效和不良反应.临床受益反应率明显优于对照组(50% vs 22%,P<0.05);观察组中位生存期和1年生存率也明显优于对照组(P<0.05);主要不良反应为白细胞下降、胃肠道反应,均较对照组轻,其它不良反应两组相似均可耐受.结论:吉西他滨联合5-氟尿嘧啶治疗晚期胰腺癌近期临床疗效较高,不良反应可以耐受.     

吉西他滨和顺铂联合用药治疗晚期胰腺癌患者利弊的Meta分析

目的:通过Meta分析，探讨吉西他滨和顺铂联合与吉西他滨单药治疗晚期胰腺癌的优缺点。方法:计算机检索中国知网、维普、万方数据库及中国生物医学数据库、PubMed、Sciencedirect、Embase、Cochrane Database、OVID Medline、Springer Link、EBSCO数据库，筛选观察组为吉西他滨与顺铂联合用药，对照组为吉西他滨单药治疗晚期胰腺癌的试验。检索期限为建库至2018年3月31日，同时手工查阅检索相似文献及参考文献。以上资料均由两位研究者独立进行文献筛选和资料提取，采用Review Manager 5.3软件进行Meta分析，计算结果以HR或OR值及95%置信区间（95%CI）表示。结果:共纳入文献12篇，包括观察组850例和对照组753例。Meta分析结果显示:疗效方面，总生存期、1年生存率及半年生存率方面吉西他滨和顺铂联合用药与吉西他滨单独用药无明显区别［HR总生存期=0.97，95%CI为（0.83，1.12）,P=0.65＞0.05；OR1年生存率=1.02，95%CI为（0.76，1.38），P=0.89＞0.05；OR半年生存率=1.12，95%CI为（0.77，1.64），P=0.56＞0.05］；而客观缓解率（ORR）则具有边缘性统计意义［OR客观缓解率=1.54，95%CI为（1.00，2.37），P=0.05］；毒副反应方面，吉西他滨和顺铂联合用药的毒副作用明显高于吉西他滨单独用药［OR3/4度中性粒细胞减少=1.70，95%CI为（1.27，2.27），P=0.000 4＜0.05；OR3/4度血小板减少=1.96，95%CI为（1.55，2.49），P＜0.000 01；OR胃肠道毒副作用=2.98，95%CI为（1.95，4.55），P＜0.000 01］。结论:吉西他滨联合顺铂治疗晚期胰腺癌虽然在ORR中能使患者受益，但不能使患者获得比单用吉西他滨更好的临床疗效及远期预后，反而使中性粒细胞减少、血小板减少及胃肠道反应等毒副反应加剧。因此，临床上不应提倡吉西他滨联合顺铂用药作为一线临床用药，应选用更加合理有效的化疗用药方案。     

晚期肺鳞癌一线吉西他滨/紫杉醇与铂类二联方案疗效比较

目的:比较晚期肺鳞癌患者一线吉西他滨/紫杉醇与铂类二联方案的临床疗效,为晚期肺鳞癌患者个体化化疗方案筛选提供临床依据。方法:回顾性分析2008年6月至2012年5月经病理确诊的、一线应用吉西他滨或紫杉醇铂二联方案化疗的转移性肺鳞癌患者62例,分为2个治疗组,每组患者均为31例。结果:吉西他滨铂二联方案客观有效率为32.3%,紫杉醇铂二联方案客观有效率为35.5%,二者比较差异不具有统计学意义（P=0.737);两组患者中位无进展生存期分别为5个月（95%CI 3.2-6.8个月）和5个月（95%CI 3.7-6.3个月）,二者比较差异不具有统计学意义（P=0.058);两组患者中位生存期分别为10个月（95%CI 8.9-11.1个月）和12个月（95%CI 9.7-14.3个月）,二者比较差异不具有统计学意义(P=0.087)。结论:在晚期肺鳞癌中,吉西他滨/紫杉醇铂二联方案的疗效相似,其中紫杉醇铂二联具有生存优势。     

LFPH和LF方案对晚期大肠癌近期疗效比较

[目的]比较醛氢叶酸、氟尿嘧啶、顺铂和羟基喜树碱(LFPH)方案与醛氢叶酸、氟尿嘧啶(LF)方案对晚期大肠癌的疗效及毒副反应.[方法]晚期大肠癌47例,随机分为2组:治疗组24例采用LFPH方案的联合化学治疗.对照组23例,采用LF方案化疗.[结果]治疗组有效率54.2%,对照组26.1%,治疗组高于对照组.主要毒副反应是轻中度骨髓抑制和胃肠道反应.[结论]LFPH方案治疗晚期大肠癌有效率较高,毒副反应可耐受,可在临床进一步观察使用.     

吉西他滨单药及联合用药治疗晚期胰腺癌的疗效对比:一项针对Ⅲ期随机对照临床试验的荟萃分析

背景与目的：晚期胰腺癌的治疗效果较差，生存期也较短。吉西他滨是治疗晚期胰腺癌的一线药物，有研究表明吉西他滨联合用药对患者的生存有益。本研究通过荟萃分析对比吉西他滨单药和联合用药在治疗晚期胰腺癌中的疗效。方法：检索MEDLINE、EBMreviews、EMBASE等数据库，查阅有关文献。所选Ⅲ期随机对照试验的研究对象为晚期胰腺癌，单药治疗组接受吉西他滨单药化疗，联合治疗组接受吉西他滨联合（铂类、喜树碱类，抗代谢素或靶向类）药物治疗。两名评价员独立检索资料。评价指标包括6个月、1年生存率及ORR（客观缓解率）等。结果：共检索出19篇符合要求的文章。荟萃分析结果显示联合治疗组1年生存率较单药治疗组高，两组间差异有显著性（RR：0．87，95％可信区间：[0．78，0．96]，P=0．008）。结论：吉西他滨联合用药可能有效提高晚期胰腺癌患者的生存率。     

吉西他滨或卡培他滨联合放疗治疗局部晚期胰腺癌的临床研究

摘 要：［目的］ 探讨吉西他滨或卡培他滨联合放疗治疗局部晚期胰腺癌的疗效和安全性。［方法］ 34例不可手术切除的局部晚期胰腺癌患者,分为吉西他滨联合放疗组(A组,17例)和卡培他滨联合放疗组(B组,17例)。观察两组患者的有效率、不良反应及生存情况。［结果］ A组与B组总有效率分别为70.6% vs 41.2%,1年生存率58. 8% vs 35.3%,2年生存率29.4% vs 17.6%,1年局部控制率52.9% vs 35.3%,2年局控率23.5% vs 11.8%,均显示出A组有较好的生存和局部控制优势,但两组差异无统计学意义（P>0.05）。A组血液学不良反应发生率较B组高,而B组消化道不良反应发生率较A组高,多为Ⅰ/Ⅱ级,患者可耐受,两组不良反应差异无统计学意义（P>0.05）。［结论］ 吉西他滨联合外放疗治疗局部晚期胰腺癌有一定的疗效优势。     

Comparative Study of Gemcitabine Plus Cisplatin and Gemcitabine Plus Fluorouracil 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 a GP group (gemcitabine + cisplatin, 30 cases) and a GF group (gemcitabine + fluorouracil, 30 cases). All patients were treated with gemcitabine at a dose of 1,000mg/m² (diluted in 100ml saline solution over 30 min) once a week for 3 consecutive weeks. The GP Group was followed by 40mg cisplatin via intravenous drip on days 15,16,17. Group GF was followed by 500mg/m²5-Fu (diluted in 5% glucose-saline (GS) 500ml, intravenously, over 6 hr) every day for five subsequent days. Results In the GP group, eight cases (32.0%) were PR and MR, the median survival time was 8.7 months, the Clinical Beneficial Rate (CBR) was 57.7%, and the CA19-9 decreased by over 50% in 13 cases (48.1%). In the GF group, 11 cases (45.8%) were PR and MR, the survival time was 10.1 months, the CBR was 82.1%, and CA19-9 decreased by over 50% in 15 cases(53.6%). There was a significant difference in the CBR between the two groups (P<0.05). The main toxicities in both groups were leucopenia and thrombocytopenia with no significant difference. Conclusions The treatment given to either the GP or GF group is a feasible and well-tolerated chemotherapy regimen for treating advanced pancreatic cancer with improved therapeutic efficacy and few side effects. The median survival period is long and the CBR is high, especially with the GF regimen.     

PS-341 and gemcitabine in patients with metastatic pancreatic adenocarcinoma: a North Central Cancer Treatment Group (NCCTG) randomized phase II study.

BACKGROUND: PS-341 is a proteasome inhibitor with preclinical activity in pancreatic cancer tumor models and synergistic activity with gemcitabine. This randomized phase II study determined the tumor response rate (RR) for PS-341 alone and the 6-month survival and RR for the combination of gemcitabine and PS-341 in patients with metastatic pancreatic adenocarcinoma. PATIENTS AND METHODS: Patients were randomized to receive 3-week cycles of either arm A: PS-341 1.5 mg/m(2) i.v. bolus (over 3--5 s) on days 1, 4, 8 and 11 or arm B: PS-341 1.0 mg/m(2) (same as arm A otherwise) plus gemcitabine 1,000 mg/m(2) i.v. on days 1 and 8. Patients progressing on arm A were allowed to receive arm B treatment. RESULTS: Arm A: 42 evaluable patients were enrolled with a confirmed RR of 0% (95% CI 0% to 8%), median survival of 2.5 months (95% CI 2.0-3.3), and median time to progression (TTP) of 1.2 months (95% CI 1.1--1.3). Twelve of 43 evaluable patients (28%) experienced at least one grade 4+ AE. Arm B: 39 evaluable patients yielded a 6-month survival rate of 41% (16/39, 95% CI 29.8% to 67.0%), median survival of 4.8 months (95% CI 2.4--7.4), median TTP of 2.4 months (95% CI 1.5--3.1), and confirmed RR of 10% (4 partial responses/0 complete responses, 95% CI 3% to 24%). Eleven of 43 evaluable patients (26%) experienced at least one grade 4+ AE. One patient had grade 5 hypotension. CONCLUSION: The use of PS-341 alone or in combination with gemcitabine did not result in an overall survival and RR better than that expected for gemcitabine alone. Based on the lack of efficacy and the toxicity seen in our trial, there does not appear to be a role for PS-341 in pancreatic adenocarcinoma with either of the schedules used in this trial.     

晚期胰腺癌的持续腹腔动脉插管化疗

为了观察和评价晚期胰腺癌持续腹腔动脉插管化疗效果,对７例晚期胰腺癌患者行腹腔动脉插管并留置,６例采用ＴＨＰＡＤＭ＋ＨＣＰＴ＋ＣＦ／５Ｆｕ方案,另１例采用Ｇｅｍｃｉｔａｂｉｎｅ＋ＣＦ／５Ｆｕ方案,持续滴注４ｄ。结果完全缓解１例,部分缓解３例,无变化２例,进展１例,有效率为５７．１％（４／７）,临床受益疗效７１．４％（５／７）。２例已死亡,５例生存,中位生存期５个月。结果表明持续腹腔动脉插管化疗对晚期胰腺癌有较好疗效,值得临床进一步观察研究。     

Phase II study of biweekly gemcitabine followed by oxaliplatin and simplified 48-h infusion of 5-fluorouracil/leucovorin (GOFL) in advanced pancreatic cancer

Purpose

To evaluate the efficacy and safety profile of a triplet regimen consisting of gemcitabine, oxaliplatin, and infusional fluorouracil and leucovorin (LV) in advanced pancreatic carcinoma (APC).

Patients and methods

Chemotherapy-naïve patients with histo-/cytologically proven unresectable APC, and bi-dimensionally measurable diseases were eligible. Treatment consisted of fixed-dose rate (10 mg/m²/min) infusion of 800 mg/m² gemcitabine followed by 2-h infusion of 85 mg/m² oxaliplatin and then 48-h infusion of fluorouracil and LV (3,000 and 300 mg/m², respectively) every 2 weeks (the GOFL regimen). The primary end-point was objective response rate.

Results

Forty-five patients were enrolled and received a median of seven [95% confidence interval (CI) 6.4–8.8] cycles of treatment. On intent-to-treat analysis, the overall response and disease-control rates were 33.3% (95% CI 21.4–48.0%) and 68.9% (95% CI 54.8–83.0%), respectively. Clinical benefit response was observed in 46.2% of initially symptomatic patients. The median time-to-tumor progression and overall survival were 5.1 (95% CI 4.0–6.3) months and 8.7 (95% CI, 6.1–11.3) months, respectively. Major grade 3–4 toxicities were neutropenia (28.9%, with 4.4% complicated with fever), peripheral sensory neuropathy (15.6%), nausea/vomiting (13.3%), and diarrhea (6.7%).

Conclusions

The triplet regimen is feasible and exhibits promising activity against APC, deserving further exploration.     

Activity of gemcitabine and continuous infusion fluorouracil in advanced pancreatic cancer

BACKGROUND/OBJECTIVES: Gemcitabine has been shown to improve survival and quality of life parameters compared to fluorouracil alone in advanced pancreatic cancer [J Clin Oncol 1997;15:2403-2413]. However, fluorouracil was given as a weekly bolus in that study and other administration schedules might be more effective. The objective of this trial was to determine the activity and toxicity of gemcitabine in combination with continuous infusion (CI) fluorouracil in advanced pancreatic cancer. PATIENTS AND METHODS: Chemotherapy-na?ve patients with measurable advanced adenocarcinoma of the pancreas were treated with gemcitabine 1,000 mg/m(2) intravenously weekly x 3 followed by 1 week of rest every 4 weeks and 200 mg/m(2)/day CI fluorouracil until disease progression or limiting toxicity. RESULTS: Twenty-five patients were evaluable for response and toxicity. Objective partial responses were documented in 5 patients (20%; 95% confidence interval 6.8-40.7%) and disease stabilization or minor responses in 13 patients (52%; 31.3-72.2%). Toxicity was mild with grade 2/3 leucopenia in 26%, stomatitis in 15%, nausea in 6%, diarrhea in 3%, and hand-foot syndrome in 2% of the treatment cycles. In 3 patients a catheter thrombus occurred and in 1 patient the treatment had to be stopped due to asthenia. The performance status improved in 39% of the patients and 65% benefitted in terms of a decrease in pain intensity or consumption of analgesics. CONCLUSION: This phase II trial confirms a significant antitumor activity and a beneficial clinical effect of gemcitabine plus CI fluorouracil in advanced pancreatic cancer. The combination is well tolerated and it will have to be shown whether oral fluoropyrimidines can increase the practicability of this treatment without impairing efficacy.     

吉西他滨单药或与顺铂联合治疗胰腺癌的临床疗效评价

目的 评价吉西他滨单药以及与顺铂联合治疗局部晚期或转移性胰腺炎的疗效。临床受益反应,生存时间和毒性反应。方法 42例患者随机分为吉西他滨单药组（A组20例）和吉西他滨 顺铂联合组（B组22例）,A组;吉西他滨1000mg/m^2,每周1次,连用7周,休息1周;随后相同剂量每周1次,连用3周,休息1周,B组;吉西他滨1000mg/m^2,每周1次,连用3周,顺铂60mg/m^2,第15天给药,休息1周,每4周重复,边境用药3个周期。结果 42例患者中,可评价客观疗效者34例（A组16例,B组18例,可评价临床受益反应（CBR）者36例（A组16例,B组20例）,可进行毒性反应评估者40例（A组19例,B组21例）,A组：PR1例（6.3%)。MR4例（25.0%),SD7例（43.8%)。PD4例（25.0%)。B组;PR2例（11.0%)。MR3例（16.7%),SD8例（44.4%),PD5例（27.8%)。PR MR SD率A组为75.0%。B组为72.2%。CBR有效率A组为87.5%(14/16),B组为70.0%(14/20)。两组3个月生存率均为100%,6个月生存率分别为81.3%和61.6%。12个月生存率分别为31.3%和11.1%。B组Ⅲ、Ⅳ度血液学毒性反应发生率略高于A组,两组相比,差异无显著性。结论 吉西他滨单药以及与顺铂联合一线治疗局部晚期或转移性胰腺癌有一定的客观疗效。可明显改善患者的生活质量。延长了生存时间,患者耐受良好。     

Activity and toxicity of oxaliplatin and bolus fluorouracil plus leucovorin in pretreated colorectal cancer patients: a phase II study

The aim of the current study was to evaluate the activity and toxicity of a combination of oxaliplatin with bolus fluorouracil and leucovorin in colorectal cancer (CRC) patients pretreated for advanced disease with various schedules including continuous fluorouracil infusion. Thirty consecutive patients with pretreated advanced CRC received oxaliplatin 130 mg/m2 by 2-h infusion dl, leucovorin 100 mg/m2 by 1-h infusion followed by fluorouracil 425 mg/m2 i.v. bolus from day 1 to 3 every 3 weeks for a maximum of 6 cycles. The best overall response rate in an intent-to-treat analysis was 13% (2 complete responses and 2 partial responses) (95% CI, 1.2-25.5%) and 37% of patients obtained stable disease with a tumor growth control rate of 50% (95% CI, 32.1-67.9%). The median progression-free survival was 4.0 months (95% CI, 1.4-6.5 months) and median overall survival was 12.0 months (95% CI, 9.9-14.1 months). The independent prognostic factors for improved overall survival were a good performance status and a response/stabilization of disease to chemotherapy. Severe neutropenia was quite common (43.3% of patients and 14.4% of cycles), although complicated by fever only in one case (3.3% of patients). There was one toxic death. In conclusion, the study combination showed an interesting rate of tumor growth control in a cohort of patients previously treated for advanced disease with various schedules including continuous fluorouracil infusion.     

A Northern California Oncology Group randomized trial of leucovorin plus 5-fluorouracil versus sequential methotrexate, 5-fluorouracil, and leucovorin in patients with advanced colorectal cancer who failed treatment with 5-fluorouracil or 5-fluorodeoxyuridine alone

The current study was initiated to confirm preliminary reports that 20% or more of patients with colorectal cancer who fail treatment with 5-fluorouracil (FUra) will respond to treatment with either leucovorin plus FUra or with sequential methotrexate, FUra, leucovorin. One hundred two patients with advanced, measureable colorectal cancer who failed treatment with FUra and/or 5-fluorodeoxyuridine (FUdR) were randomized to treatment with either high-dose leucovorin plus FUra (Arm B) or sequential methotrexate, FUra, leucovorin (Arm C). In this interim report, 92 patients were evaluable for toxicity and 89 patients were evaluable for response. Grade 3 or 4 nonhematologic toxicity which was primarily gastrointestinal was experienced by 25% of patients on both treatment arms during at least 1 treatment cycle. Hematologic toxicity was minimal. Among 43 evaluable patients on Arm B, there were 2 complete responses (5%) and 1 minor response (3%). Among 46 evaluable patients on Arm C, there was 1 complete response (2%), 1 partial response (2%), and 6 minor responses (14%). The median time to treatment failure was 2.2 months on Arm B and 3.5 months on Arm C. The median survival was 8.3 months on Arm B and 8.7 months on Arm C. Colorectal cancers that are resistant to FUra are cross-resistant to both experimental combinations.     

经动脉持续灌注化疗治疗中晚期胰腺癌的临床分析

 目的 比较经动脉持续灌注化疗和全身静脉化疗治疗中晚期胰腺癌的临床疗效，探讨选择性动脉持续灌注化疗的临床应用价值。方法 51例中晚期胰腺癌，其中25例采用经动脉持续灌注吉西他滨和5-Fu方案，26例采用经外周静脉灌注吉西他滨和5-Fu方案。应用世界卫生组织实体瘤疗效评定标准评价疗效，肿瘤体积测量采用MRI或CT。使用临床受益反应（CBR）对疼痛、体力状况及体重改变情况作出综合评价。采用WH0抗肿瘤药物急性与亚急性毒性分级标准对不良反应进行评价。结果 动脉灌注化疗组的有效率（32．0％）高于外周静脉化疗组（23．1％），但差异无显著性。动脉灌注化疗组的临床受益率（80．0%）高于外周静脉化疗组（50．0％），差异有显著性。6个月、9个月、1年的累积生存率和中位生存时间，动脉灌注化疗组高于外周静脉化疗组，差异有显著性。按WHO分级标准，两组患者不良反应之间无显著性的差异。结论 经动脉持续灌注吉西他滨和5-Fu较外周静脉灌注吉西他滨和5-Fu能提高中晚期胰腺癌的临床受益率和生存期，其方法安全可靠，且不良反应少。