不可切除的胰腺癌预后相关因素分析

Prognostic factors analysis in 128 patients with unresectable pancreatic carcinoma

目的探讨影响不可切除的胰腺癌患者预后的主要因素。方法回顾性分析128例晚期胰腺癌患者的临床资料，包括年龄、性别、族别、既往糖尿病病史，化疗，放疗，ECOG评分和肿瘤标志物CA19—9升高情况等对总生存的影响。应用Kaplan—Meier进行生存分析，组间比较用Logrank检验，多因素分析采用Cox比例风险模型。结果总的中位生存期为6．8个月，1年生存率为23．3％。单因素分析显示，年龄、化疗、放疗和ECOG评分对预后有关。Cox比例风险模型显示，仅化疗和ECOG评分对预后有关。结论不可切除胰腺癌的预后与年龄、化疗、放疗和ECOG评分相关，对于不可切除且一般状况好的患者可以考虑化疗，部分患者也可考虑联合放疗。

Objective To analyze the most important factors affecting the prognosis of patients with unresectable pancreatic carcinoma. Methods The clinical data of 128 patients with unresectable local or metastatic pancreatic cancer were analyzed retrospectively, including gender, age, race, diabetes mellitus history, Eastern Collaborative Oncology Group （ ECOG ） scoring, chemotherapy, radiotherapy and CA19 - 9 levels. Survival analysis was performed by Kaplan - Meier method, comparison among/between groups was performed using log rank test, and multivariate analysis was carried out using Cox proportional hazard model. Results The median survival time was 6.8 months and the 1 - year survival rate was 23.3%. Univariate analysis showed that age, ECOG scoring, chemotherapy and radiotherapy were significant factors（P 〈 0. 05 ）. Multivariate analysis showed that only ECOG scoring and chemotherapy were independent prognostic factors. Conclusion The patients with unresectable pancreatic carcinoma who have better ECOG scoring, younger age and receive chemotherapy or radiotherapy show better survival. Chemotherapy and sometimes combined radiotherapy can be considered in patients with good performance status.