白蛋白结合型紫杉醇一线治疗晚期胰腺癌的疗效与安全性

目的:探讨白蛋白结合型紫杉醇(Nab-P)治疗晚期胰腺癌的疗效与安全性。方法:回顾性分析2012年10月至2014年12月98例晚期胰腺癌患者的临床资料，根据是否一线接受Nab-P化疗分为Nab-P组和对照组，其中Nab-P组58例，对照组40例。Nab-P组中，11例接受Nab-P联合吉西他滨治疗，47例接受Nab-P联合替吉奥治疗；对照组中，18例接受吉西他滨+顺铂化疗，22例接受替吉奥治疗。每2个周期评价疗效，每周期评价不良反应。观察患者的近期疗效、PFS、OS及不良反应。结果:两组患者年龄、性别、转移灶数目及既往治疗等基线资料无明显差异（P＞0.05）。Nab-P组的ORR和DCR均明显高于对照组（ORR:53.4% vs 25%，P＜0.05；DCR:96.6% vs 50%）。Nab-P组中位PFS为5.6个月，对照组中位PFS为3.3个月；Nab-P组中位OS为10.5个月，对照组中位OS为5.3个月。经log-rank分析，Nab-P组的PFS、OS均明显长于对照组（P＜0.05）。两组III级及以上血液学毒性、恶心、呕吐、乏力及周围神经毒性的发生率无明显统计学差异。结论:采用白蛋白结合型紫杉醇与化疗结合治疗晚期胰腺癌可以提高患者的生存时间，安全性好。

Efficacy and safety of albumin bound paclitaxel in the treatment of patients with advanced pancreatic cancer

Objective:To evaluate the efficacy and safety of albumin bound paclitaxel in the treatment of advanced pancreatic cancer.Methods:Medical records of 98 patients with advanced pancreatic cancer from October 2012 to December 2014 were retrospectively analyzed.All patients were divided into two groups,58 cases in Nab-P group and 40 cases in control.In Nab-P group,11 patients received Nab-P combined with gemcitabine and 47 patients received Nab-P combined with S1,while in the control,18 cases received gemcitabine combined with cisplatin and 22 patients received S1.The efficacy was evaluated every two cycles and adverse reactions were evaluated every cycle.The endpoint of the study was short-term efficacy,PFS,OS and adverse reactions.Results:Baseline data such as age,gender,number of metastatic lesions and previous treatment,had no significant difference between the two groups.ORR and DCR of Nab-P group were significantly higher than those of the control(ORR:53.4% vs 25%,P＜0.05;DCR:96.6% vs 50%).mPFS of Nab-P group was 5.6 months and that of the control was 3.3 months,while mOS of Nab-P group was 10.5 months and that of the control group was 5.3 months.By log-rank analysis,PFS and OS of Nab-P group were both significantly longer than that of the control group (P＜0.05).Incidence rate of grade III-IV hematologic toxicity,nausea,vomiting,fatigue and peripheral neurotoxicity had no significant difference between the two groups.Conclusion:Albumin bound paclitaxel combined with chemotherapy in the treatment of advanced pancreatic cancer can improve the survival time of patients,and the safety is good.