61例老年不可切除胰头癌临床治疗分析

Clinical Analyses of 61 Cases of Senility Cancer of the Head of Pancreas

目的探讨不可切除老年胰头癌患者低毒有效的临床治疗模式。方法61例老年不可切除胰头癌患者均接受胆肠吻合术。术后随机分为3组:A组22例术后给予吉西他滨(GEM)单药化疗2～4周期;B组20例给予GEM加5-氟脲嘧啶(5-FU)联合化疗2～4周期;C组19例给予GEM加顺氯氨铂(DDP)联合化疗2～4周期。观察3组患者临床受益反应及不良反应发生情况,随访统计半年、1年生存率。结果61例患者术后黄疸有不同程度减退。A、B、C组临床受益率分别为68.2%、50.0%、57.9%。A、B、C组的半年生存率分别为63.6%、60.0%、63.2%;A、B、C组的1年生存率分别为36.4%、35.0%、42.1%。结论老年不可切除胰头癌患者行胆肠吻合术后GEM单药化疗有确切疗效,且毒性小,患者可很好耐受。以GEM为主的联合化疗未能较单药提高生存率,原因有待于进一步探讨。

Objective To observe the effects of multi-treatment of senility cancer of the head of pancreas. Methods Sixty--one cases of senility cancer of the head of pancreas were divided into three groups： group A was given chemotherapy of gemcitabine; group B was combined chemo- therapy of gemcitabine and 5-fluorouracil; group C was combine-chemotherapy of gemcitabine and cisplatin. All three groups were treated for 2--4 weeks. The clinical benefit response（CBR）, side--effects, and the rates of 6--month-- and one--year--survival were observed. Results The CBRs of groups A,B,C were 68.2% ,50.0% and 57.9% respectively. The half-year survival rates of groups A,B,C were 63. 6%, 60. 0% and 63. 2%o respectively; the 1-year survival rates of groups A, B, C were 36.4 %, 35.0 % and 42.1% respectively. Conclusion GEM showed a definite therapeutic effect with little side--effect in senility cancer of the head of pancreas. The patients could be bear the treatment.