吉西他滨动脉灌注化疗与外周静脉化疗治疗中晚期胰腺癌的比较研究

目的 比较吉西他滨动脉灌注化疗和外周静脉化疗治疗中晚期胰腺癌的临床疗效,旨在评估吉西他滨动脉灌注化疗的有效性和安全性.方法 按照纳入标准,43例中晚期胰腺癌患者被纳入研究,其中21例采用动脉灌注化疗(灌注组),22例采用外周静脉化疗(静脉组),两组均采用吉西他滨为基础联合5-FU化疗.主要评价指标包括l临床受益反应、肿瘤客观缓解率和不良反应.结果 灌注组的临床受益率为8l%,显著高于静脉组的50%(P=0.033);灌注组的疼痛改善率为76.2%,亦显著高于静脉组的45.5%(P=0.039);灌注组的肿瘤客观有效率为33.3%.略高于静脉组的22.7%,相差不显著(P=0.498);两组不良反应无显著性差异.结论 与外周静脉化疗相比,吉西他滨动脉灌注化疗能显著提高中晚期胰腺癌患者的临床受益率,其不良反应轻微,患者耐受性良好.

Gemcitabine arterial infusion chemotherapy versus intravenous chemotherapy for patients with advanced pancreatic cancer: a comparative study

Objective To compare the clinical efficacy of gemcitabine arterial infusion chemotherapy with intravenous chemotherapy in the management of patients with advanced pancreatic cancer and to evaluate the efficacy and safety of gemcitabine arterial infusion chemotherapy. Methods 43 patients with advanced pancreatic cancer were included in this study, of whom 21 patients received arterial infusion chemotherapy (Group A) and the other 22 were treated by intravenous chemotherapy (Group B), gemcitabine combined with 5-FU chemotherapy was administrated in both groups. The main outcomes were clinical benefit response (CBR), tumor response rate and toxicity. Results Compared with Group B, there was a significant improvement of CBR in group A (81% vs 50%, P =0.033) ; there was also significant improvement of pain control in group A (76.2% vs 45.5%, P =0.039). There was no significant difference in the tumor response rate between two groups (33.3% vs 22.7%, P =0.498). No significant increase of side effects was observed in both groups. Conclusions In the management of advanced pancreatic cancer, the arterial infusion method may be more favorable than intravenous approach in improving clinical benefits with mild toxicity and well tolerability.