45例胰腺癌临床疗效分析

Clinical evaluation of the therapeutic efficacy in 45 cases of pancreatic carcinoma

目的探讨胰腺癌不同治疗方式与临床疗效及预后的关系。方法将2000年1月至2006年12月收治的45例胰腺癌患者的临床资料进行回顾性分析,用COX比例风险模型对可能影响胰腺癌疗效的指标进行多因素分析,并用Kaplan-Meier法计算生存率。结果总有效率CR+PR为82.2%);1,2年生存率分别为24.4%和8.9%;中位生存期8个月。单因素分析显示,Karnofsky评分、肿瘤位置、CA-199、是否手术、临床分期、治疗情况、近期疗效、CBR与治疗疗效存在相关性。多因素分析显示,Karnofsky评分≥70分;CA-199疗前升高,治疗后恢复正常者;近期疗效达CR/PR者可望提高生存率。结论 Karnofsky评分、CA-199、近期疗效是影响胰腺癌预后的因素。

Objective To investigate the relation between different therapy and the clinical efficacy,prognosis for pancreatic carcinoma.Methods Forty-five patients with pancreatic carcinoma during Jan-Dec,2006,were retrospectively studied according to treatment methods.The factors influencing survival were analyzed using univariate analysis（Log-rank） and multivariate（COX′s proportional hazard regression model） analysis methods.Results The overall response rate was 37/45（82.2%）.The 1-,2-year survival rates were 11/45（24.4%）,4/45（8.9%） and the median survival duration was 8 months.The single factor analysis showed that KPS scores,the tumor site,CA-199,whether operation or not,clinical stage,the therapy methods,the curative effect and CBR had influence on survival period.Multivariate analysis showed that the patients who had KPS scores≥70,increase in level of pretreatment baseline CA-199 and decrease in level of CA-199 after therapy and short-term curative effect attaining CR/PR were hopeful of prolonging survival.Conclusion KPS scores,CA-199,the curative effect were the significant factors affecting the survival.