联合化疗治疗晚期胰腺癌的疗效分析

EFFECT OF GEMCITABINE PLUS 5-FLUOROURACIL AND FOLINIC ACID TO TREAT THE PATIENTS WITH ADVANCED PANCREATIC ADENOCARCINOMA

目的 探讨吉西他滨和 5 -氟尿嘧啶联合治疗晚期胰腺癌的疗效和可能的影响机制。方法 实验组 2 2例接受吉西他滨、5 -氟尿嘧啶和四氢叶酸联合化疗 ,对照组 2 1例接受 5 -氟尿嘧啶 +四氢叶酸联合化疗 ,比较他们的近期疗效、疾病相关症状改善状况和不良反应。通过高效液相色谱技术检测第 1、5天时 2组病人 5 -氟尿嘧啶的血浆浓度和半衰期。结果 实验组病人的近期疗效、疾病相关症状改善均好于对照组 ,但不良反应也增加。实验组病人血浆中 5 -氟尿嘧啶的血药浓度增高 ,半衰期延长 ,上述变化贯穿于 5 -氟尿嘧啶的整个治疗过程。结论 吉西他滨可改善 5 -氟尿嘧啶治疗晚期胰腺癌的疗效 ,其机制与它能长时间的提高 5

Objective To investigate the effects and the mechanism of gemcitabine plus 5-fluorouracial and folinic acid for patients with advanced pancreatic adenocarcinoma.Methods 43 untreated patients were collected and divided into two groups:the experimental group who received chemotherapy with gemcitabine(1000mg/m 2 in a intravenous on days 1,8 and 16,plus folinic acid(100mg/m 2)and 5-FU(400mg/m 2)administered by a i.v.infusion on days1-5;the control group received FA and 5-FU in the same way.5-FU pharmacokinetics were compared in two groups.Result The objective response was 31.8% and DRSI was 68.2% in the experimental group,which was respectively 14.3% and 33.3% respectively in the control group.There was a significant increase in systemic(5-FU) exposure and toxicity in the experimental group.Conclusion It is certain for the combined application of gemcitabine and 5-FU to treat pancreatic adenocarcinoma.The enhanced 5-FU systemic exposure found in the presence of GEM may explain the higher level of toxicity and antitumour activity in this trial.