吉西他滨单药化疗与联合化疗治疗进展期胰腺癌的疗效观察

目的观察比较吉西他滨单药与联合化疗治疗进展期胰腺癌的疗效。方法回顾性分析了大连医科大学附属一院2002年至2009年收治的45例进展期胰腺癌患者的临床资料,吉西他滨单药组17例,剂量为1000mg/m2,d1、8,三周为一周期;吉西他滨联合治疗组28例,联合化疗方案包括吉西他滨1000mg/m2,d1、8,分别联合：（1）氟尿嘧啶425～600mg/m2,静滴或持续静脉泵入,d1～5;（2）顺铂60～75mg/m2,分3～4d静脉滴入;（3）奥沙利铂85～130mg/m2,d1,静脉滴入;（4）卡培他滨1000mg/m2,每天两次口服,d1～14。21d为一周期。采用Kaplan-Meier生存曲线分析患者的生存期,并比较两组间的临床受益率、中位疾病进展时间、中位生存时间及不良反应。结果吉西他滨联合组及单药组的临床收益率均得到提高,但两组间比较临床受益率、疾病控制率、中位生存时间均无统计学意义。结论吉西他滨联合化疗方案与吉西他滨单药治疗进展期胰腺癌相比,疗效、临床受益率、中位生存期均相似。

Efficacy of gemcitabine-based chemotherapy and gemcitabine monotherapy in treatment of advanced pancreatic cancer

Objective To observe the efficacy of gemcitabine（GEM）-based combination therapy and gemcitabine monotherapy in treatment of advanced pancreatic cancer.Methods Forty-five cases of pancreatic cancer were analyzed retrospectively.They were admitted to the No.1 Affiliated Hospital of Dalian University and Dalian No.3 hospital during Jan 2002 to June 2009.Of the 45 cases,17 were treated with gemcitabine（1000 mg/m2）alone weekly for two weeks followed by one week＇s rest;28 patients were treated with gemcitabine（1000 mg/m2）weekly for two weeks plus 5-Fu（425-600 mg/m2）as bolus on days 1-5 or 120-hour infusion every 21 days,or DDP（60-75 mg/m2）divided into 3-4 days every 21 days,or oxaliplatin（85-130 mg/m2）on day 1 every 21 days,or capicitabine（1000 mg/m2）twice a day on days 1-14 every 21 days.The survival was analyzed by Kaplan-Meier method.Median time to progression（mTTP）,clinical benefit response（CBR）,disease control rate,median overall survival（mOS）and toxicity were assessed according to World Health Organization criteria.Results The rate of CBR both in GEM-combination group and GEM alone group was lengthened.But there were no significant differences in disease control rate,mOS,CBR,and adverse events between the two groups（all P0.05）.Conclusion GEM-combination regimens and GEM alone have similar efficacy,and lead to similar clinical benefit response and mOS in the patients with advanced pancreatic cancer.