吉西他滨联合奥沙利铂对晚期胰腺癌合并肝转移的临床疗效观察

摘要

目的:探讨吉西他滨联合奥沙利铂对晚期胰腺癌合并肝转移的临床疗效及其安全性.方法:回顾性研究84例晚期胰腺癌伴有肝转移的患者,根据化疗方案分为实验组和对照组,每组42例,实验组给予吉西他滨联合奥沙利铂化疗(GEMOX方案),对照组给予5-FU化疗,治疗4周后,比较两组临床受益率、治疗有效率、无疾病进展生存期、1年生存率和不良反应的发生情况.结果:当转移癌体积小于肝体积75％时,对照组的临床受益率为6.06％,有效率为12.12％,而实验组的临床受益率为32.26％,有效率为58.06％,与对照组的患者相比均显著升高(P＜0.05).实验组中位无疾病进展生存期为18个周,21％的患者2年内达到无疾病进展,患者的平均生存期为37个周,在1年生存率为35％；而对照组中,中位无疾病进展生存期为9个周,1年生存率为0,实验组1年生存率显著高于对照组者(P＜0.05).两组不良反应发生情况无明显差别.结论:吉西他滨联合奥沙利铂治疗晚期胰腺癌合并肝转移的疗效优于以5-FU为主的化疗,且二组相比不良反应无明显差别,值得临床进一步研究.%Objective: To investigate the therapeutic effect and security of gemcitabine plus oxaliplatin on the treatment of advanced pancreatic carcinoma with hepatic metastasis. Methods: 84 cases of advanced pancreatic carcinoma with hepatic metastasis were selected and randomly divided into experimental group and control group 42 cases in each group. Patients in the experimental group were treated with gemcitabine plus oxaliplatin (GEMOX treatment), while patients in the control group were only treated with 5-FU. The clinical benefit rate, response rate, progression free survival, 1-year survival rate and incidence of adverse effects were compared after four weeks' treatment. Results: When the volume of metastatic carcinoma was less than 75% of liver, the clinical benefit rate and response rate in control group were respectively 6.06% and 12.12%, while those were respectively 32.26% and 58.06% in experimental group, both of which were significantly higher than that of control group (P＜0.05). Progression free survival in the experimental group was 18 weeks, and 21% cases in experimental group reached progression free survival within two years. The average survival time was 37 weeks, and 1-year survival rate was 35% in experimental group. While in the control group, the progression free survival was 9 weeks, and 1-year survival rate was 0, which was significantly lower than that of experimental group (P <0.05). There is no difference in the incidence of adverse effects. Conclusion: The therapeutic effect of gemcitabine plus oxaliplatin on the treatment of advanced pancreatic carcinoma with hepatic metastasis was superior to that of 5-FU therapy, and the adverse reactions caused by the two therapy showed no obvious difference. Thus the gemcitabine plus oxaliplatin treatment deserves further clinical research.