联合铂类化疗改善晚期胰腺癌预后

目的探讨治疗晚期胰腺癌的有效药物。方法选择病理诊断明确的Ⅲ～Ⅳ期胰腺癌患者,至少接受2周期以上吉西他滨、氟尿嘧啶及铂类化疗,电话回访生存期,分析不同药物治疗后生存期变化。结果 95例晚期胰腺癌患者中位生存期7.1月,1年生存率30.5%,2年生存率8.4%,3年生存率3.2%。Cox单因素生存模型分析显示,Ⅳ期患者较Ⅲ期患者生存期短（P=0.002,HR：2.09,95%CI：1.31～3.35）,联合铂类化疗方案治疗患者较未联合患者生存期长（P=0.011,HR：0.56,95%CI：0.35～0.88）,胰体尾癌较胰头颈部癌患者生存期有缩短趋势,但差异无统计学意义（P=0.062,HR：1.53,95%CI：0.98～2.38）。Cox多因素生存模型分析显示,Ⅳ期患者较Ⅲ期患者死亡风险增加（P=0.026,HR：1.83,95%CI：1.08～3.10）,联合铂类化疗能降低晚期胰腺癌死亡风险（P=0.026,HR：0.59,95%CI：0.38～0.94）。结论Ⅳ期胰腺癌患者较Ⅲ期患者预后差,联合铂类化疗可能延长晚期胰腺癌生存期。

Chemotherapy combined with platinum prolongs survival of patients with advanced pancreatic cancer

Objective To evaluate the efficacy of chemotherapy combined with platinum for patients with advanced pancreatic cancer. Methods Patients with stage Ⅲ and Ⅳ pancreatic cancer received at least 2 cycles of gemcitabine and/or fluorouracil regimens.The survival of patients was analyzed with Cox regression analysis. Results The median survival time of 95 patients was 7.1 months,the one-,two-and three-year survival rates were 30.5%,8.4% and 3.2%,respectively.Cox monopolar proportional hazards model analysis found that patients with stage Ⅳcancer had significantly less survival than those with stage Ⅲ(P=0.002,HR: 2.09,95% CI: 1.31~3.35).Patients receiving chemotherapy regimens including platinum had longer survival than those not including platinum(P=0.011,HR: 0.56,95% CI: 0.35~0.88).Patients with pancreatic body and tail tumors tended to have less survival than those with pancreatic head and neck tumors,but there was no statistical difference(P=0.062,HR: 1.53,95% CI: 0.98~2.38).Cox multivariate proportional hazards model analysis found that a higher mortality risk in stage Ⅳ patients(P=0.026,HR: 1.83,95% CI: 1.08~3.10) and a lower mortality risk in patients receiving chemotherapy regimens including platinum(P=0.026,HR: 0.59,95% CI: 0.38~0.94). Conclusions Tumor stage is an independent prognostic factor for pancreatic cancer.chemotherapy combined with platinum regimens may prolong survival of patients with advanced pancreatic cancer.