替吉奥与吉西他滨同步放化疗治疗局部晚期胰腺癌的临床研究

Concurrent chemoradiotherapy with S-1 and gemcitabine for locally advanced pancreatic cancer

目的探讨替吉奥联合吉西他滨同步放化疗治疗局部晚期胰腺癌的疗效和安全性。方法选择26例不可手术切除的局部晚期胰腺癌患者,随机分为替吉奥联合吉西他滨同步放化疗组(观察组,13例)和5氟尿嘧啶(5-FU)联合吉西他滨同步放化疗组(对照组,13例)。观察组给予替吉奥40mg/m2,bid,第1～18天;同时给予吉西他滨1000mg/m2第1天、第5天、第29天,应用6 MV直线加速器,接受总放疗剂量54 Gy、27次。对照组给予5-Fu 750mg/m2,第1～4天、第25～28天;吉西他滨的用法及放疗方法均同观察组。结果观察组总有效率为38.5%,1年生存率为53.8%,与对照组比较有生存优势。观察组不良反应较轻,患者耐受性更好,生活质量明显改善。结论替吉奥联合吉西他滨同步放疗治疗局部晚期胰腺癌患者临床疗效好,不良反应明显轻,患者耐受性良好。

Objective To evaluate the efficacy and safety of S - 1/gemcitabine with concurrent ra- diotherapy for locally advanced pancreatic cancer （LAPC）. Methods 26 LAPC patients were randomly di- vided into observation group （S -1/gemeitabine with concurrent radiotherapy group） and control group （5 -Fu/gemeitabine with concurrent radiotherapy group）. All patients received gemcitabine （1000mg/m2 d1, d15, d29） and radiotherapy with a total dose of 54Gy with 6blV linear accelerator. S - 1 was adminis- tered orally （40mg/m^2, bid, dl -28 ） in observation group, while 5 - Fu was administered with 750mg/ma （dl -4, d25 - 28） in control group. Results In the observation group, the overall response rate and 1 - year survival rate was 38.5% and 53.8%, respectively. The side effects of the observation group were mild, and the quality of life improved significantly. Conclusions S - 1 plus gemcitabine with concurrent radiotherapy is considered to be a feasible and effective treatment with mild toxicity for LAPC.