【摘要】 背景与目的:晚期胰腺癌是恶性程度很高的肿瘤,全身化疗是其主要的治疗方法。本研究拟观察、比较三种不同化疗方案对晚期胰腺癌的客观疗效及其临床受益反应。方法:对我科2000年2月～2001年4月期间收治的经病理检查证实的74例晚期胰腺癌患者的临床资料进行回顾性分析,其中26例采用5-氟尿嘧啶、醛氢叶酸、顺铂方案治疗(A组);23例采用吉西他滨单药治疗(B组);25例采用吉西他滨联合5-氟尿嘧啶、醛氢叶酸方案治疗(C组)。采用Kaplan-Meier法分析患者生存期,Cox比例风险回归模型分析影响预后的因素。结果:A、B、C三组客观缓解率分别为7.7%、17.4%与24.0%,三组间无显著性差异(P=0.261,χ2检验);临床受益反应率分别为19.2%、47.8%与60.0%,B、C组优于A组,差异具有显著性(P<0.05,χ2检验)。A、B、C三组中位生存期分别为6.50个月(95%CI=5.00,7.99)、8.03个月(95%CI=6.72,9.35)、8.79个月(95%CI=7.31,10.26),B、C组长于A组,差异有显著性(Breslow=8.85,P=0.0119)。三组间血液学毒性和非血液学毒性发生率差异无显著性。结论:吉西他滨与5-氟尿嘧啶、醛氢叶酸联合作为一线方案治疗晚期胰腺癌有一定的客观缓解率,可改善患者的生活质量,患者耐受良好,值得进一步研究。更多还原

【Abstract】 BACKGROUND & OBJECTIVE: Advanced,unresectable panc- reatic c ancer is an extremely aggressive disease. Systemic chemotherapy is the most freq uently administered treatment for the patients with advanced pancreatic cancer. This clinical trial was designed to compare the efficacy, clinical benefit respo nse (CBR), and toxicity profile of three regimens in treating advanced pancreati c cancer (APC). METHODS: From February 2000 to April 2001,74 patients of patholo gically advanced pancreatic cancer were analyzed retrospect- ively. Of 74 APC patients, 26 received 5- fluorouracil+ leucovorin+ cisplatin (Arm A), 23 rece ived gemcitabine (Arm B) and 25 treated with gemcitabine+ 5- fluorouracil+ le ucovorin (Arm C). Kaplan- Meier method was used for analysis of survival rate a nd Cox regression model was used for analysis of prognostic factors. RESULTS: Th e overall response rates and CBRs were 7.69% and 19.23% in Arm A, 17.39% a nd 47.83% in Arm B, 24.0% and 60.0% in Arm C. There was no significant dif ference in the overall response rate(P=0.261,Chi- square test) and a significan t difference in CBR among three groups(P< 0.05, Chi- square test). The median s urvival time were 6.5 months for Arm A(95% CI 5.00,7.99 months),8.03 months for Arm B(95% CI 6.72,9.35 months) and 8.79 months for Arm C (95% CI 7.31,10.26 m onths). There were significant differences among three groups in the median surv ival time(Breslow=8.85,P=0.0119) . There was no significant difference in the i ncidence of hematological and nonhematological toxicity among three groups.CONCL USION:The combination of gemcitabine,5- fluorouracil and leucovorin is a modera tedly active treatment with tolerable side effects. It has definite response rat e and also significantly improve the quality of life in patients. Its treatment value is worth further studying.更多还原