Clinical Benefitからみた進行膵癌に対するGemcitabineの有用性

摘要

膵癌は発見時に進行例が多いため化学療法への期待は大きいが，奏効率は依然として低いのが現状である。 しかし，本邦で新規に保険適応されたgemcitabine（GEM）は，症状の緩和や延命効果に寄与するとの報告がある。そこで本稿では，GEM単独投与を施行した切除不能膵癌13例を対象に，5－fluorouracil/cisplatin（FP）療法を施行した13例をhistorIical controlとし，治療成績，副作用，症状緩和効果（clinical benefitresponse）につき比較した。 GEMの奏効率は7.7％（1/13）と低かったが，76.9％（10/13）がprolonged NCと判定され，延命効果に寄与していた（p＝0.0025）。 症状緩和効果は，GEMでは38.5％（5/13），FP療法では7.7％（1/13）にみられ，前者でよい傾向にあった（p＝0.063）。 GEMは投与方法も簡便で，患者のQOLを損なうこともないため，Clinical benefitからみて，現在，進行膵癌に対する第一選択の治療法として有用と考えられる。 Since pancreatic cancers are frequently discovered in an advanced stage, the expectations for chemotherapy are high, However, the response rate to chemotherapy of advanced cancer remains low,. In Western countries, gemcitabine (GEM), a newly approved drug in Japan, was reported to be useful in improving symptoms and prolonging survival, In the present study, we compared 13 patients with unresectable advanced pancreatic cancer who were treated with GEM alone and 13 patients with pancreatic cancer treated with 5-fluorouracil/cisplatin (FP) as historical controls, with reference to therapeutic results, adverse reactions, and clinical benefit response,. Although the response rate to GEM was low, at 7.7% (1/13), prolonged NC was seen in 76.9% (10/13) of cases, suggesting a contribution to prolonged survival (p = 0.0025). A clinical benefit response was seen in 38.5% (5/13) of the GEM group, as compared with the lower rate of 7.7% (1/ 13) in the FP group (p = 0.063), Since GEM is convenient to administer, and does not diminish a patient's QOL, it is considered to be useful as a drug of first choice in the treatment of advanced pancreatic cancer in terms of clinical benefits,.