动脉灌注吉西他滨治疗晚期胰腺癌临床研究

Transcatheter arterial infusion of gemicitabine for treatment of advanced pancreatic cancer

目的 评价吉西他滨（健择）动脉灌注治疗晚期胰腺癌的疗效和安全性。方法 对20例胰腺癌病人采用吉西他滨动脉灌注结合静脉化疗,并与9例采用5-氟尿嘧啶（1000mg）、阿霉素（40～50mg）、卡铂（200mg）经胰十二指肠动脉灌注治疗的胰腺癌病人为对照,对病人的疾病相关症状改善、疗效和毒副反应进行评价。结果 吉西他滨组治疗后疼痛改善率为75％,对照组疼痛改善率为44.4％,两者比较无显著性差异。治疗后Karnofsky评分吉西他滨组好转率为60％,对照组为44.4％。吉西他滨组部分缓解率（PR）为30％,半年及1年生存率分别为85％及25％,中位生存时间为9.2个月;对照组PR为22.2％,半年生存率为66.7％,无1年生存者,中位生存时间为7.9个月（P>0.05）。两组均有不同程度的胃肠道和骨髓抑制等不良反应（P>0.05）,3、4级不良反应较少见。结论 吉西他滨动脉灌注治疗晚期胰腺癌能够改善病人的生存质量,延长病人的生存期,无严重毒副反应。

Objectives The aim of the study was to assess the effect of gemicitabine by transcatheter arterial infusion on pancreatic cancer. Methods Twenty patients with advanced pancreatic cancer were given gemicitabine (1 000mg/m2)by arterial and intravenous infusion and other 9 patients treated with 5-fluorouracil (1 000 mg), adriamycin (40 ?50 mg), carboplatin (200 mg) by arterial infusion were used as control. Pain relief, improvement of Karnofsky score, efficacy and side effects of both groups were evaluated. Results Pain relief rate was 75% in gemicitabine group and 44. 4% in control group; there was no significant difference between two groups. The Karnofsky score got better in 60% patients of gemicitabine group, and in 44. 4% patients of control group. The partial remission (PD) rate was 30% in gemicitabine group, and 22. 2% in control group. The one-year and 6-month survival rates were 25% and 85% respectively in gemicitabine group, and 0 and 66. 7% in control group. The mean survival time was 9 months in gemicitabine group and 7. 9 months in control group. Toxicity was low and well tolerated in both groups. Conclusions Transcatheter arterial infusion of gemicitabine relieved pain and improved Karnofsky score and prolonged lifetime of patients with advanced pancreatic cancer. There were no severe side effects.