吉西他滨联合体外高频热疗治疗晚期胰腺癌的疗效观察

Gemcitabine combined with high-frequency hyperthermia for patients with advanced pancreatic carcinoma

目的观察吉西他滨联合体外高频热疗治疗晚期胰腺癌的近期疗效和安全性。方法 48例晚期胰腺癌患者分为两组,治疗组24例给予吉西他滨化疗联合体外高频热疗:吉西他滨1000 mg/m2,静脉滴注30 min,第1、8、15天给药,2 h后和第2、9、16天行上腹部体外高频热疗,每次45 min。对照组24例仅给予吉西他滨单药静脉化疗:吉西他滨1000 mg/m2,静脉滴注30 min,第1、8、15天给药。28天一个周期,至少2个周期以上,按RECIST1.1的标准评价疗效,同时综合评估临床受益反应指标:疼痛、体力状况及体重变化。参照Karnofsky评分(KPS)变化评价生活质量(QOL),按照NCI CTC 3.0版标准评价毒性反应。结果治疗组有效率(RR)为25.0%,疾病控制率(DCR)为66.7%,临床受益反应率(CBR)为70.9%;对照组有效率为16.7%,疾病控制率45.8%,临床受益反应率为50.0%。治疗组和对照组各项指标相比有明显差异(P<0.05)。不良反应主要与化疗药物有关的骨髓抑制和消化道反应,两组无明显差异(P>0.05)。结论吉西他滨联合体外高频热疗治疗晚期胰腺癌具有较好的近期疗效,不增加化疗的毒副作用,安全性好,值得临床上推广应用和进一步深入研究。

Objective： To observe the the efficacy and safety of gemcitabine combined with high-frequency hyperthermia for patients with advanced pancreatic carcinoma.Methods：All the 48 patients with advanced pancreatic carcinoma were divided into two groups.Twenty-four patients in the treatment group were given chemotherapy gemcitabine（1000mg /m2,iv 30min,d1,8,15） combined with High-frequency hyperthermia（after 2h and d 2,9,16）.Twenty-four patients in the control group were given chemotherapy gemcitabine（1000 mg /m2,iv 30min,d1,8,15）.28 days were one cycle.The curative effects were estimated according to the criteria of RECIST,and the clinical benefit response rate（CBR） was evaluated.The CBR refered to pain,physical status and body weight.Quality of life（QOL） was evaluated according to karnofsky scores,and safety was evaluated according to NCICTC 3.0 version criteria.Results：There was no complete response among all the patients.The response rate,the disease control rate and the clinical benefit response rate in the treatment group were higher than those in the control group（P0.05）.The toxicities were mainly marrow depression and alimentary tract reactions related with chemotherapy agents（P0.05）.Conclusion：Gemcitabine combined with high-frequency hyperthermia for patients with advanced pancreatic carcinoma is an effective safty method,and the toxicity is tolerable.It is worthy of clinical application and further clinical observation.