5-氟尿嘧啶缓释剂植入治疗局部进展期胰腺癌

The role of slow-release 5-fluorouracil implantation in treatment of unresectable pancreatic cancer

目的 探讨5-氟尿嘧啶（5-Fu）缓释剂植入治疗局部进展期胰腺癌的效果和安全性.方法 将85例局部进展期胰腺癌患者随机分为两组：试验组50例,行术中5-Fu缓释剂植入;对照组35例,仅行术中穿刺组织细胞学诊断,加或不加内引流术.观察客观疗效、临床受益反应、不良反应、并发症及生存情况.结果 试验组部分缓解6例,稳定32例,进展12例,临床受益率为52.0%.无明显毒性反应,2例发生胰瘘,均经保守治疗治愈.试验组和对照组中位生存时间分别为9.0和4.0个月,6个月生存率分别为56.8%和31.4%,12个月生存率分别为22.9%和2.9%,两组生存率差异有统计学意义（P=0.012）.结论 5-Fu缓释剂植入治疗局部进展期胰腺癌有一定疗效,能延长患者生存时间,提高患者生活质量,无明显毒副作用,是一种安全有效的治疗方法.

Objective To study the role of slow-release 5-fluorouracil implantation in treatment of unresectable pancreatic cancer. Methods 85 cases of untreated patients with locally advanced pancreatic cancer （LAPC） were randomized into two groups： Trial group： slow-release 5-fluorouracil implantation （50 patients） and control group （35 patients）. Observing the objective tumor response, clinical benefit response, toxicity, complications and survival of patients of the two groups. Results In the trial group the overall response rate （PR ＋ NC） was 76.0%, and the clinical benefit response rate was 52.0%. No toxicity was observed. Pancreatic fistula occurred in 2 patients. The median survival time of the two groups was 9.0 months and 4.0 months, respectively. The survival rates of 6- and 12- month were 56.8% vs. 31.4% and 22.9% vs. 2.9% in the two groups, respectively （P = 0. 012）. Conclusion Slow-release 5-fluorouracil implantation is a simple, safe and effective method in treatment of LAPC.