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。

A Clinical Study on Continuous Transarterial Infusion Chemotherapy with Gemcitabine and 5-fluorouracil in Treating Patients with Advanced Pancreatic Carcinoma

Objective To compare the clinical efficacy and application between transarterial infusion chemotherapy and systemic venous chemotherapy in treating patients with advanced pancreatic carcinoma. Methods Of 51 advanced pancreatic carcinoma patients, 25 received gemcitabine combined with 5-fluorouracil via transarterial continuous infusion chemotherapy (group A). 26 cases received gemcitabine combined with 5-fluorouracil via systemic venous chemotherapy (group B). Tumor response rate, clinical benefit response (CBR) and toxicity were observed. All of the date was analyzed with SPSS 13.0 statistics software. Results The tumor response rate was 32.0 % in group A, and 23.1 % in group B, but there was no significant difference in the tumor response rate (P= 0.475 , Chi-square test). The clinical benefit response (CBR) were 80.0 % and 50.0 % respectively, and there was a significant difference in CBR between two groups (P= 0.025 , Chi-square test). There was a significant difference between two groups (P= 0.002 , Chi-square test) of the 6-month,9-month,1-year survival rates and median survivals. According to WHO criterion, There was no significant difference in the incidence of hematological and nonhematological toxicity between two groups. Conclusion The combination gemcitabine and 5-fluorouracil via continuous transarterial infusion chemotherapy in treating patients with advanced pancreatic carcinoma is a moderatedly active treatment. It has definite response rate and also significantly improve the quality of life in patients. Its treatment value is worth further studing.