GEMOX方案和FOLFOX方案一线治疗晚期十二指肠癌的疗效观察

目的 探讨GEMOX方案和FOLFOX方案一线治疗晚期十二指肠癌的疗效和安全性。方法 回顾分析本院2008年6月至2016年1月收治的30例晚期十二指肠癌患者的临床及随访资料，其中10例未接受化疗，20例接受化疗（GEMOX方案9例、FOLFOX方案11例），分别采用RECIST 1.1版与NCI-CTC 4.0版标准评价疗效和不良反应，Kaplan-Meier法进行生存分析。结果 GEMOX方案和FOLFOX方案均无CR和PR病例，其中GEMOX方案获SD 6例、PD 3例，疾病控制率（DCR）为66.7％，FOLFOX方案获SD 4例、PD 7例，DCR为36.4％，两组DCR的差异无统计学意义（P＞0.05）。GEMOX方案和FOLFOX方案的中位总生存期（OS）分别为27.9个月和15.2个月（P=0.179）；GEMOX方案的中位无进展生存期（PFS）为8.0个月，优于FOLFOX方案的4.4个月，差异有统计学意义（P=0.038）。常见不良反应多为1～2级，主要为白细胞减少、中性粒细胞减少、乏力、恶心、皮疹等。20例接受化疗患者的中位OS为26.9个月，优于10例未接受化疗的4.4个月，差异有统计学意义（P＜0.001）。结论 化疗可延长晚期十二指肠癌患者的生存时间。GEMOX方案和FOLFOX方案均对晚期十二指肠癌一线治疗有效，且耐受性良好，其中GEMOX方案的中位PFS可能更长。

Clinical observation of GEMOX and FOLFOX regimens as first-line chemotherapy for advanced duodenal cancer

Objective To evaluate the efficacy and safety of GEMOX and FOLFOX regimens as first-line chemotherapy for advanced duodenal cancer.Methods From June 2008 to Jan 2016, 30 advanced duodenal cancer patients were analyzed.Only 20 patients received chemotherapy, including 9 patients of GEMOX regimen and 11 patients of FOLFOX regimen as first-line chemotherapy.The efficacy and safety were evaluated by RECIST 1.1 and NCI-CTC 4.0 criteria.Overall survival (OS) and progression-free survival (PFS) were analyzed by Kaplan-Meier method.Results Among patients receiving chemotherapy, CR and PR were not observed.For GEMOX regiem, 6 cases of SD and 3 cases of PD were observed with disease control rate (DCR) of 66.7%.For FOLFOX regiem, 4 cases of SD and 7 cases of PD were observed with DCR of 36.4%.No difference in DCR was observed between different regimes (P>0.05).The median OS of GEMOX and FOLFOX regimes were 27.9 months and 15.2 months(P=0.179).The median PFS of GEMOX regime was 8 months, superior to 4.4 months of FOLFOX regime (P=0.038).The major treatment-related side effects included leucopenia, neutropenia, nausea, vomiting, fatigue, erythra and etc, mainly in grade1-2.The median OS of patients receiving chemotherapy was 26.9 months, superior to 4.4 months of patients receiving non-chemotherapy (P<0.001).Conclusion Chemotherapy was effective in advanced duodenal cancer.Both GEMOX and FOLFOX regimes were effective and well-tolerated in the first-line chemotherapy.GEMOX had a longer PFS in first-line chemotherapy.