吉西他滨不同输注法联合奥沙利铂方案治疗进展期胰腺癌的疗效评价

Therapeutic evaluation of GEMOX regimen in treatment of patients with advanced pancreatic cancer

目的观察吉西他滨固定剂量率输注法联合奥沙利铂方案对进展胰腺癌化疗疗效及毒副反应。方法选择90例初治、进展期胰腺癌患者，按简单随机法分为两组，均采用吉西他滨联合奥沙利铂（GEMOX）方案，其中研究组46例采用吉西他滨固定剂量率输注，对照组44例采用吉西他滨30min标准输注，每21d重复。每例患者完成4周期至少2周期化疗，评价两组疗效及毒副反应。结果研究组客观缓解率（ORR）、临床获益率及临床受益反应（CBR）均优于对照组，差异有统计学意义（P〈0．05）。毒副反应主要为血液学毒性，尤其Ⅲ～IV度白细胞、血小板减少发生率，研究组明显高于对照组（P〈0．05）；而非血液学毒副反应发生率与对照组组差异无统计学意义。结论吉西他滨固定剂量率输注法联合奥沙利铂方案治疗进展期胰腺癌方法可行，具有较高的客观缓解效率及临床受益反应；非血液学毒副反应发生率较低，患者耐受性较好；但其血液学毒性较为显著，需引起足够重视。

Objective To investigate the chemotherapeutic efficacy and toxic-side reaction of a fixed dose rate infusion of gem- citabine combined with oxaliplatin in treatment of patients with advanced pancreatic cancer. Methods Ninety newly-diagnosed patients with advanced pancreatic cancer were randomly divided into experimental group（ n=46）and control groups （n= 44 ）. Patients in the experimental group received chemotherapy with fixed dose rate infusion of gemcitabine combined with oxaliplatin while patients in the control group received the regimen of gemcitabine 30 min standard infusion combined with oxaliplatin. The therapeutic process was 21 days. Each patient received at least two cycles of treatment. The chemotherapeutic efficacy and toxicities were compared between the two groups. Results The objective response rate （ORR）and clinical benefit response （CBR）in the experimental group were significantly higher than that in the control group （P 〈 0. 05 ）. In respect of adverse events, the major side effect was hematological toxicity. The rate of grade m/iv leucoeytopenia and thromboeytopenia in the experimental group was remarkably higher than that in the control group（ P 〈 0.05 ）. However, no significant difference in the rate of non-hematological toxicity was found between the two groups. Conclusion The GEMOX regimen is feasible and effective scheme in the treatment of advanced pancreatic cancer with higher ORR and CBR. Non- hematological toxicity is well-tolerated. However, hematological toxicity is distinguished that needs to cause enough attention.