吉西他滨联合奥沙利铂方案合并高强度聚焦超声治疗晚期胰腺癌的疗效观察

Efficacy of Gemcitabine plus Oxaliplatin Combined with High Intensity Focused Ultrasound in the Treatment of Advanced Pancreatic Cancer

目的探讨吉西他滨联合奥沙利铂方案(GEMOX方案)合并高强度聚焦超声(HIFU)治疗晚期胰腺癌的近期疗效和不良反应。方法选择经组织病理学或细胞学确诊的晚期胰腺癌患者52例,分为观察组和对照组各26例。对照组采用静脉滴注,吉西他滨1 000 mg/m2,第1,8天,奥沙利铂130 mg/m2第1天治疗,每21天重复。观察组在对照组的基础上增加高强度聚焦超声治疗,比较2组的近期疗效和不良反应。结果观察组完全缓解1例(3.8%)、部分缓解10例(38.5%)、稳定5例(19.2%)、进展10例(38.5%),有效率为42.3%。对照组完全缓解0例、部分缓解6例(23.1%)、稳定7例(26.9%)、进展13例(50.0%),有效率为23.1%。观察组RR率明显高于对照组(P<0.05)。观察组临床受益反应(CBR)57.7%,对照组34.6%,2组比较,差异显著(P<0.05)。观察组无胃肠穿孔、出血、腹膜炎等并发症发生。结论吉西他滨联合奥沙利铂方案合并高强度聚焦超声治疗晚期胰腺癌可获得较好的近期疗效,且未出现不良反应,值得临床进一步推广应用。

Objective To evaluate the short-term efficacy and adverse reactions of gemcitabine plus oxaliplatin com-bined with high intensity focused ultrasound in the treatment of advanced pancreatic cancer .Methods 52 patients histologically or cytologiaclly confimed to be advanced pancreatic cancer were divided into the observation group and the control group , each with 26 cases.The control group were treated with gemcitabine 1 000 mg/m2 D1 and D8,plus oxaliplatin 130 mg/m2 D1 every 21 days.The observation group received high-intensity focused ultrasound therapy on the basis of the control group .Short-term effica-cy and adverse reactions of the 2 groups were compared .Results The effective rate of the observation group was 42.3%inclu-ding 1 CR(3.8%),10 PR(38.5%),5 SD(19.2%),10 PD(38.5%);and the effective rate of the control group was 23.1%, including 0 CR,6 PR(23.1%),7 SD(26.9%),13 PD(50.0%).The response rate of the observation group was significantly higher than that of the control group (P<0.05).The clinical benefit response rate of the observation group was 57.7%,and that of the control group was 34.6%,the difference of the 2 groups was significant(P<0.05).There were no gastrointestinal perfora-tion,hemorrhage ,peritonitis and other complications in the observation group .Conclusion Gemcitabine plus oxaliplatin com-bined with high intensity focused ultrasound in the treatment of advanced pancreatic cancer has good short -term efficacy without adverse reactions ,and it is worthy of further clinical application .