老年晚期胰腺癌患者对吉西他滨联合顺铂化疗耐受性分析

目的 探讨老年晚期胰腺癌患者对吉西他滨联合顺铂化疗的耐受性.方法 对2004年1月至2009年1月收治的34例老年(>70岁)晚期胰腺癌患者的临床资料进行回顾性分析.结果 34例患者均行吉西他滨联合顺铂化疗,其中6例获得部分缓解(partial remission,PR),16例疾病稳定(stable disease,SD),临床获益率64.7%.18例患者治疗后镇痛药物用量减少≥50%,疼痛强度VAS评分下降35%以上;22例患者体力状况明显提高,体重增加≥7%.恶心、呕吐发生率为38.2%(13/34),4例巩膜皮肤黄染加重,肝功能异常,化疗2个周期中断治疗.Ⅲ～Ⅳ度骨髓抑制的发生率为34.6%,白细胞、血红蛋白、血小板均有不同程度的下降.血小板减少率28.3%(12/34),应用G-CSF治疗后血常规可恢复正常.无外周神经毒性发生,无化疗相关死亡.结论 老年胰腺癌,行为状态良好者可耐受吉西他滨联合顺铂方案化疗.

The chemotherapy tolerance of gemcitabine and cisplatin in old patients with advanced pancreatic cancer

Objective To investigate the tolerance of chemotherapy based on gemcitabine and cisplatin in elderly patients (> 70 years old) with advanced pancreatic cancer. Methods Retrospective analysis in 34 elderly patients with advanced pancreatic cancer between January 2004 and January 2009 was performed. Results 6 patients had partial remission (PR) and 16 patients had stable diaease (SD). The clinical benefit response (CBR) rate was 64.7%. 18 patients reduced their analgesics dose exceeding 50% , as well as pain intensity descended exceeding 35% , 22 patients had the weight increased more than 7% and had improved general well-being. The incidence rate of nausea and vomiting was 38. 2% (13/34) , 4 patients had worsened liver function and aggravated skin and sclera stained yellow. Incidence of Ⅲ- Ⅳ myelosuppressive was 34. 6% , and there were decrease in the number of white blood cell, hemoglobin, platelets to some extent, the rate of thrombocytopenia was 28. 3% (12/34) , blood routine normalized after using G-CSF. There was no occurrence of peripheral neurotoxicity or chemotherapy-related death. Conclusions Chemotherapy of gemcitabine in combination with cisplatin was tolerable for elderly patients with advanced pancreatic cancer who were in good condition of behavior.