目的 观察吉西他滨联合厄洛替尼治疗晚期或进展期胰腺癌的临床疗效、获益反应和不良反应.方法 回顾性分析12例接受吉西他滨联合厄洛替尼治疗的局部晚期或转移性胰腺癌患者的临床资料.所有患者均接受至少两个周期吉西他滨联合厄洛替尼的治疗.吉西他滨于第1天和第8天800～1000mg/m2静脉滴注,每21 d为一个周期;厄洛替尼口服150mg/d.治疗两个周期后复查CT评价疗效.结果 1例因腹泻严重退出.11例患者中无达到完全缓解者,1例(9.09%)获得部分缓解,6例(54.5%)病情稳定,4例(36.4%)病情进展,疾病控制率为63.6%,临床获益率为72.7%,中位无进展生存期为4.5个月.中位生存期8.4个月.血液学毒性发生率为75.0%,其中Ⅲ～Ⅳ度白细胞下降的发生率为25.0%,Ⅲ～Ⅳ度血小板下降发生率为8.3%.皮疹发生率为41.7%,均为Ⅰ～Ⅱ度,1例出现Ⅲ度腹泻退出,4例出现Ⅰ度转氨酶升高.无化疗相关的死亡.结论 吉西他滨联合厄洛替尼治疗晚期胰腺癌,可以延长生存时间,提高生活质量,总体临床耐受性好.%Objective To evaluate the efficacy, clinical beneficial response, and toxicity of gemcitabine combined with erlotinib in advanced pancreatic adenocarcinoma. Methods Clinical data of 12 patients with advanced pancreatic cancer was reviewed retrospectively. Gemcitabine was administered as 1 000 mg/m2 weekly for 3 weeks,while erlotinib was administered orally 150 mg/day. Therapeutic effects were evaluated after 2 treatment cycles. Resuits 1 patient exited because of Ⅲ° Diarrhea. There were 11 of the 12 patients might be evaluated for the objective response. No patient achieved complete rernission. The disease control rate was 63.6%, including 1 PR and 6 SD patients, and clinical benefit rate was 72.7%. The median progression free survival was 4.5 months, and the median overall survival was 8.4 months. The total incidence of hematologic toxicity was 72%, including 25.0% of grade 3-4 leucopehia and 8.3% of grade 3-4 thrombocytopenia. The other side effects were rash, diarrhea, inflammation of oral cavity, gastrointestinal tract response and slight liver function damage. No chemotherapy-related death occurred. Conclusion Gemcitabine combined with erlotinib is an effective regimen for pancreatic cancer with good clinical tolerance.
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