姑息化疗和最佳支持治疗在晚期胰腺癌中的比较

目的 评价姑息化疗在提高晚期胰腺癌病人生存期方面的意义，本文所指的姑息化疗均是以5—FU为基础的。方法通过MEDLINE、EMBASE等数据库检索国内外已发表和未发表的相关文献。选择治疗组为姑息化疗并对症支持治疗，对照组为只给予对症支持治疗的晚期胰腺癌的随机对照试验。由2位评价者分别按上述检索策略收集资料，按选择标准入选，主要对半年生存率及1年生存率进行Meta分析。结果 姑息化疗与最佳支持治疗对比，治疗晚期胰腺癌使半年生存率提高21％，使1年生存率提高6％，但均无统计学意义。结论 目前姑息化疗可以选择性地用于晚期胰腺癌，部分病人可能获益，但仍不能作为标准治疗。

A comparison of 5-FU-based chemotherapy with best supportive care in inoperable pancreatic cancer

Objectives To evaluate chemotherapy effects on survival in patients with inoperable pancreatic cancer. Methods MEDLINE and EMBASE searches were supplemented by information from trial registers. RCT(rando-mized clinical trial) for 5-FU-based chemotherapy and best supportive care in inoperable pancreatic cancer. A quantitative meta-analysis,using updated information based on inclusion and exclusion criteria from all available RCT,was carried out by two reviewers. The meta-analysis was based on 6 months' survival and 1 year's survival. Results 21% relative increase was obtained in patients with inoperable pancreatic cancer treated by 5-FU-based chemotherapy compared with best supportive care on 6 months' survival. And 6% relative increase was obtained in patients with inoperable pancreatic cancer treated by 5-FU-based chemotherapy compared with best supportive care on 1 year's survival. Both of the results have no significant statistical difference. Conclusion There is no convincing evidence that a large fraction of inoperable pancreatic cancer patients will benefit from intravenous 5-FU-based chemotherapy. Intravenous 5-FU-based chemotherapy in inoperable pancreatic cancer can only be recommended selectively and should preferably be used within controlled clinical trials. Trying to resolve the problem,we should perform a series of controlled, prospective, randomized, double-blind, well-designed, multi-center trials.