【摘要】 目的探讨GEMOX方案和FOLFOX方案一线治疗晚期十二指肠癌的疗效和安全性。方法回顾分析本院2008年6月至2016年1月收治的30例晚期十二指肠癌患者的临床及随访资料,其中10例未接受化疗,20例接受化疗(GEMOX方案9例、FOLFOX方案11例),分别采用RECIST 1.1版与NCI-CTC 4.0版标准评价疗效和不良反应,Kaplan-Meier法进行生存分析。结果 GEMOX方案和FOLFOX方案均无CR和PR病例,其中GEMOX方案获SD 6例、PD 3例,疾病控制率(DCR)为66.7%,FOLFOX方案获SD 4例、PD 7例,DCR为36.4%,两组DCR的差异无统计学意义(P>0.05)。GEMOX方案和FOLFOX方案的中位总生存期(OS)分别为27.9个月和15.2个月(P=0.179);GEMOX方案的中位无进展生存期(PFS)为8.0个月,优于FOLFOX方案的4.4个月,差异有统计学意义(P=0.038)。常见不良反应多为1~2级,主要为白细胞减少、中性粒细胞减少、乏力、恶心、皮疹等。20例接受化疗患者的中位OS为26.9个月,优于10例未接受化疗的4.4个月,差异有统计学意义(P<0.001)。结论化疗可延长晚期十二指肠癌患者的生存时间。GEMOX方案和FOLFOX方案均对晚期十二指肠癌一线治疗有效,且耐受性良好,其中GEMOX方案的中位PFS可能更长。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of GEMOX and FOLFOX regimens as first-line chemotherapy for advanced duodenal cancer.Methods From June 2008 to Jan 2016,30 advanced duodenal cancer patients were analyzed.Only 20 patients received chemotherapy,including 9 patients of GEMOX regimen and 11 patients of FOLFOX regimen as first-line chemotherapy.The efficacy and safety were evaluated by RECIST 1.1 and NCI-CTC 4.0 criteria.Overall survival( OS) and progression-free survival( PFS) were analyzed by Kaplan-Meier method.Results Among patients receiving chemotherapy,CR and PR were not observed.For GEMOX regiem,6 cases of SD and 3 cases of PD were observed with disease control rate( DCR) of 66.7%.For FOLFOX regiem,4cases of SD and 7 cases of PD were observed with DCR of 36.4%.No difference in DCR was observed between different regimes( P>0.05).The median OS of GEMOX and FOLFOX regimes were 27.9 months and 15.2 months( P = 0.179).The median PFS of GEMOX regime was 8 months,superior to 4.4 months of FOLFOX regime( P = 0.038).The major treatment-related side effects included leucopenia,neutropenia,nausea,vomiting,fatigue,erythra and etc,mainly in grade1-2.The median OS of patients receiving chemotherapy was 26.9 months,superior to 4.4 months of patients receiving non-chemotherapy( P < 0.001).Conclusion Chemotherapy was effective in advanced duodenal cancer.Both GEMOX and FOLFOX regimes were effective and well-tolerated in the first-line chemotherapy.GEMOX had a longer PFS in first-line chemotherapy.更多还原