吉西他滨联合替吉奥对比联合奥沙利铂一线治疗晚期胰腺癌的临床疗效分析

A Comparative Analysis of Gemcitabine Combined with S-1 or Oxaliplatin as the First Line Chemotherapy for Advanced Pancreatic Cancer

目的观察和比较吉西他滨联合替吉奥(GS方案)与吉西他滨联合奥沙利铂(GEMOX方案)治疗晚期胰腺癌的近期疗效和安全性。方法选择经病理组织学或细胞学证实为胰腺癌且影像学评估无法行根治手术的49例晚期胰腺癌患者,将其随机分为吉西他滨联合替吉奥组(GS组,26例)与吉西他滨联合奥沙利铂组(GEMOX组,23例)进行治疗,观察和比较两组患者的近期临床疗效、临床受益反应、生存情况和不良反应的发生情况。结果 GS组和GEMOX组的有效率分别为46.2%和26.1%,差异无统计学意义(P=0.146);疾病控制率分别为80.8%和52.2%,差异有统计意义(P=0.033);临床受益反应率分别为92.3%和69.6%,差异有统计学意义(P=0.005);中位疾病进展时间分别为6.3月、4.5月,差异有统计学意义(P=0.007);中位生存时间分别为11.6月和9.1月,差异有统计学意义(P=0.013);严重不良事件的总发生率分别为19.2%和21.7%,差异无统计学意义(P=0.300)。结论相比于联合奥沙利铂,吉西他滨联合替吉奥治疗晚期胰腺癌的有效率更高,生存期明显延长,不良反应少且可耐受,值得临床进一步推广应用。

Objective To observe and compare the recent curative effect and safety of gemcitabine combined with s-1 （GS） or oxaliplatin （GEMOX） for advanced pancreatic cancer . Methods Forty-nine patients who were diagnosed as ad-vanced pancreatic cancer by histologic or cytology methods and could not get radical operation assessed by imageology were randomly divided into two groups. One group including 26 patients were treated with gemcitabine combined with S-1 （GS group）. The other group were treated with gemcitabine combined with oxaliplatin （GEMOX group）, including 23 patients. The patients.The curative effects, clinical benefit response, survival situation and incidence of adverse reactions were ob-served and compared between the two groups.Results The effective rate of GS group and GEMOX group were 46.2%and 26.1%respectively, without statistical differences （P=0.146）. The disease control rate of GS group and GEMOX group were 80.8%and 52.2%respectively, with significantly statistical differences （P=0.033）. The clinical benefit response rate were 92.3%and 69.6%respectively for GS and GEMOX, with statistical differences （P=0.005）. The median time of disease progression and survival time for GS and GEMOX were 6.3 months and 4.5 months （P=0.007）, 11.6 months and 9.1 months （P=0.013）, respectively with statistical differences. The total incidence of serious adverse events of GS and GEMOX group were 19.2%and 21.7%respectively, and there were no statistically significant differences （P=0.300）. Conclusion Advanced pan-creatic cancer patients could get more benefit from chemotherapy with gemcitabine plus S-1 than with gemcitabine combined with oxaliplatin. Patients with gemcitabine and S-1 treatment could have longer survival time and less adverse reactions.