Ⅱ期胰腺癌辅助治疗对患者生存的影响
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王喜艳E-mail:wxyforum@163.com

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Results of adjuvant therapy on survival of patients with stage Ⅱ pancreatic carcinoma
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    摘要:

    目的:探讨辅助治疗在Ⅱ期胰腺癌治疗中的作用。
    方法:回顾分析所收治的139例患者的临床资料,随访生存期并进行生存分析。
    结果:139例患者总体1,3,5年生存率分别为40%,6%,3%,中位生存时间279 d。其中根治性切除组、短路或探查手术组和未手术组中位生存时间分别为390 d,270 d和132 d。全组行辅助治疗和未辅助治疗者中位生存时间为399 d和210 d。根治切除术后辅助治疗并不能明显延长患者生存期或降低肝转移率(P>0.05);对未根治切除患者(包括短路或探查手术组、未手术组)辅助治疗可显著延长生存期(P<0.05),但静脉化疗、放疗、介入化疗和联合方案间生存率差异无统计学意义(P>0.05);以吉西他滨为基础方案与5-FU为基础方案比较,以及吉西他滨联合铂类或卡培他滨较与吉西他滨单药比较,生存率差异均无统计学意义(P>0.05)。
    结论:根治切除手术后,可结合患者自身状况推荐适当的辅助治疗;对未根治性切除的Ⅱ期胰腺癌,应积极开展以化、放疗为主的综合治疗,吉西他滨联合铂类或卡培他滨疗效相对较好。

    Abstract:

    Objective:To investigate the effect of adjuvant therapy on the treatment of stage Ⅱ pancreatic carcinomas.
    Methods:The clinical data of 139 patients with stage Ⅱ pancreatic carcinoma were analyzed tetrospectively.
    Results:The overall 1, 3 and 5-year cumulative survival rate of 139 patients was 40%, 6% and 3% respectively, and the median survival time (MST) was 279 days. The MST was  390 days for the radical resection group, 270 days for the bypass operation and laparotomy group, and 132 days for the non-surgical group;  and 399 days for those with adjuvant therapy, 210 days for those without adjuvant therapy; The adjuvant therapy did not significantly prolong the survival time nor decrease the liver metastasis rate in the patients with stage Ⅱ carcinoma undergoing radical resection (P>0.05). However, in the patients undergoing bypass operation, laparotomy or non-surgiery, the adjuvant therapy improved the survival significantly (P<0.05), but the survival rate was not significantly different between systemic venous chemotherapy, radiation therapy, interventional therapy and combination therapy (P>0.05); and was also not significant difference between gemcitabine (GEM) regimen and 5-fluorouracil regimen (P>0.05), or between GEM monotherapy and GEM combined with platinum/capecitabine (P>0.05).
    Conclusions:The proper adjuvant therapy can be suggested for the patients after radical resection for stage Ⅱ pancreatic carcinoma according to patient′s condition. Chemotherapy combined with radiation should be applied aggressively for the patients whose cancer was not radically resected. The clinical efficacy of GEM combined with platinum/capecitabine is relatively better than GEM alone.

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李海军| 晏冬| 温浩| 徐新建| 王喜艳.Ⅱ期胰腺癌辅助治疗对患者生存的影响[J].中国普通外科杂志,2010,19(9):957-961.
DOI:10.7659/j. issn.1005-6947.2010.09.001

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  • 收稿日期:2010-04-02
  • 最后修改日期:2010-07-14
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  • 在线发布日期: 2010-09-15