吉西他滨联合氟尿嘧啶和顺铂治疗晚期胰腺癌

Treatment of advanced pancreatic cance with gemcitabine,5-FU and cisplatine

目的 :观察吉西他滨 (GEM)、氟尿嘧啶 (5 FU)及顺铂 (DDP)三药联合化疗对晚期胰腺癌的客观疗效及其临床受益反应 (CBR)。方法 :GEM 80 0mg m2 ,5 FU 6 0 0mg m2 ,DDP 30mg m2 ,于第 1、8、15天静滴 ,2 8天为1周期 ,按WHO标准评价疗效 ,同时综合评估临床受益反应 (CBR)指标 :疼痛、体力状况及体重变化。结果 :全组共 2 9例。 2 5例化疗两周期以上 ,其中PR 6例 (2 4 0 %) ,NC 12例 (4 8 0 %) ,PC 7例 (2 8 0 %)。参照CBR综合指标 ,CBR率为 6 2 1%(18 2 9)。主要毒性为消化道反应及骨髓抑制 ,其中血小板Ⅲ—Ⅳ度毒性为 2 7 6 %(18 2 9)。失访 18例。结论 :吉西他滨联合氟尿嘧啶及顺铂对晚期胰腺癌具有一定的肿瘤客观缓解率 ,临床受益反应率高 ,毒副反应能耐受 ,值得进一步研究。

Purpose:To observe the curative effect and the clinical-benefit-response of patients with advanced pancreatic cancer who used a combine of Gemcitabine,5-FU and PDD.Methods:The treatment with Gemcitabine (800 mg/m 2) was followed by 5-FU(600 mg/m 2) and DDP (30 mg/m 2),administered on days 1,8 and 15 of 28-day schedule. The curative effect was estimated according to the standard of WHO and the clinical benefit response was evaluated at the same time. The standard of CBR included pain,physical states and body weight. Results:Twenty-five (25/29) patients received over two cycles chemotherapy. 6(24%) partial response (PR), 12 (48%) stable disease and 7(28%) progressive disease were observed. According to the standard of CBR, 18(62.1%) patients achieved the clinical-benefit-response level. Therapy was well tolerated. The main toxicities included that the alimentary tract reactions and the marrow depression. Grade 3-4 thrombocytopenia was reported in 8 (27.6%) patients. Conclusions:The combination of GEM, 5-FU and DDP is a moderatedly active treatment with tolerable side-effects. It has definite response rate and high CBR rate in pancreatic cancer.