替吉奥联合吉西他滨与单药吉西他滨治疗进展期胰腺癌的疗效比较

Comparison of of S-1 Plus Gemcitabine Versus Gemcitabine Alone in Patients with Advanced Pancreatic Cancer

关键词:  胰腺癌  替吉奥  吉西他滨  化疗

Key words:  pancreatic cancer  S-1  gemcitabine  chemotherapy

摘要:

目的 评价吉西他滨单药以及与替吉奥联合治疗局部晚期或转移性胰腺癌的有效率、临床受益反应(评价指标包括患者的疼痛强度、止痛药物消耗量、体力状况评分和体重变化)、生存时间和不良反应。方法 回顾性分析2009年1月至2011年10月收治的62例晚期胰腺癌患者，分为吉西他滨单药组(30例)和吉西他滨+替吉奥联合组(32例)。单药组：吉西他滨1 000 mg·m^-2、第1，8天，静脉滴注30 min，每3周重复。联合组：吉西他滨用法同单药组，替吉奥口服2次·d^-1，第1~14天，每3周重复。结果 62例患者均可评价客观疗效，可评价临床受益反应者56例(单药组27例，联合组29例)。单药组和联合组有效率分别为23.3％和31.3％(P<0.05)，临床受益率分别为59.2%和72.4%(P>0.05)。2组6个月生存率分别为60.0%和68.7%(P>0.05)，1年生存率分别为26.6%和31.2%(P>0.05)。中位无疾病进展时间(PFS)分别为3.9个月和5.4个月(P<0.05)，中位总生存时间分别为7.8个月和9.1个月(P>0.05)。2组不良反应比较差异无统计学意义(P>0.05)。结论 吉西他滨联合替吉奥与单药吉西他滨治疗晚期胰腺癌安全有效，前者有效率优于后者。在延长生存期方面也显示出一定的优势，但该差异无统计学意义。

Abstract:

OBGECTIVE To evaluate the the response rate(RR),clinical benefit response(CBR) and toxicity of gemcitabine and gemcitabine plus S-1 for treating locally advanced or metastatic pancreatic cancer. METHODS Sixty-two advanced pancreatic cancer patients collected from Jan 2009-Oct 2011 in our hospital. All patients were divided into two groups, control group: gemcitabine (30 patients) and treatment group: gemcitabine plus S-1 (32 patients). In control group, patients were given gemcitabine 1000 mg·m^-2 on the 1st and 8th day, intravenous drip 30 min, repeated every 3 weeks. In treatment group, patients were given gemcitabine (usage as well as control group) and S-1 taken orally, bid on the 1-14 d, repeated every 3 weeks. RESULTS All patients were available for objective response and fifty-six(27 cases in control group and 29 cases in treatment group) patients were suitable for CBR evaluation. In control group and treatment group, RR was 23.3% and 31.3%(P<0.05), CBR was 59.2% and 72.4%(P>0.05), the 6-month survival rate was 60.0% and 68.7%(P>0.05), the 12-month survival rate was 26.6% and 31.2%(P>0.05), respective. The progression-free survival (PFS) was 3.9 months and 5.4 months(P<0.05), and the median overall survival was 7.8 months and 9.1 months(P>0.05). The incidence of toxicity between the two groups was not significant difference. CONCLUSION The two kinds of chemotherapy regimens are effective and safe for treating locally advanced or metastatic pancreatic cancer. Gemcitabine plus S-1 is better than gemcitabine in RR, it also shows superiority in survival rates, but there is no significant difference bwteen two chemotherapy regimens.