生长抑素联合常规化疗对晚期胰腺癌的疗效评估

Evaluation of Curative Effect of Somatostatin Combined Chemotherapy on the Advanced Pancreatic Cancer Patients

目的:观察生长抑素联合常规化疗对晚期胰腺癌的临床疗效并评估其安全性。方法:收集2007年3月至2009年3月不能行手术切除的晚期胰腺癌55例,随机分成两组,即常规化疗对照组与生长抑素联合常规化疗组,检测治疗前后CA19-9、CEA水平、肝肾功能及血常规;分析和比较治疗有效率:治疗对肿瘤大小(实体瘤的疗效评价,RECIST标准),无进展生存期(ProgressFree Survival,PFS)、生存期和行体力状况评分的影响以及安全性评估。结果:治疗后生长抑素联合常规化疗治疗组血清CA19-9水平明显低于常规化疗对照组(P<0.05),但CEA水平没有差异;疗程结束后联合治疗组客观有效率(OR)为60%,临床获益率(CR+PR+SD)为90%;常规组客观有效率(OR)为36%,临床获益率(CR+PR+SD)为76%;联合组客观有效率和临床获益率均明显高于常规组(P<0.05)。Karnofsky评分显示联合组提高率为36.67%(11/30);而常规组提高率为24.0%(6/25),联合组Karnofsky评分的提高率明显高于优于对照组(P<0.05);联合化疗治疗组平均生存期、中位生存期分别为372.96±34.20天、345.00±30.50天,常规化疗对照组平均生存期、中位生存期分别为307.32±29.19天、290.00±28.11天。结论:生长抑素联合化疗能明显降低CA19-9的水平;同时可提高临床疗效及患者术后生活质量及生存期,能够明显提高化疗药物的抗肿瘤活性,对于改善晚期胰腺癌的预后具有重要的临床价值。

Objective： To investigate the curative effect of somatostatin combined chemotherapy on the advanced pancreatic cancer patients.Methods： 55 cases of advanced pancreatic cancer were collected from March 2007 to March 2009,and were divided into two groups randomly,the somatostatin combined chemotherapy group and the chemotherapy group.The serous levels of CA19-9 and CEA were measured in all patients before and after treatment,and curative effect was evaluated by RECIST standard,the quality of life was evaluated by using Karnofsky method,and the survival of patients was evaluated by using Kaplan-Meier.Results： There was no difference of the serous levels of CEA between two groups after treatment,but the level of CA19-9 in the combined group was much lower than that in chemotherapy group（P0.05）.The effective rate and quality of life of combined group were significantly better than those of chemotherapy group（P0.05）.Finally,the survival time in combined group was 482.96±34.56 days（mean） and 450.00±30.83 days（median）,while 347.32±29.19 days（mean） and 323.00±30.11 days（median） in chemotherapy group（P0.05）.Conclusion： Somatostatin combined chemotherapy could decrease the serous level of CA19-9,and could prolong the survival time（median and mean） and improve the quality of life of patients with advanced pancreatic cancer.Somatostatin strengthened the curative effect of chemotherapy drugs,and this method had the important clinic significance for the treatment of advanced pancreatic cancer.