替吉奥与顺铂分别联合吉西他滨治疗进展期胰腺癌疗效比较

Comparative study of gemcitabine plus S-1 and gemcitabine Plus Cisplatin in treating of advanced pancreatic cancer

目的评价吉西他滨联合替吉奥与吉西他滨联合顺铂治疗局部晚期或转移性胰腺癌临床疗效。方法回顾性分析2010年2月至2012年12月收治的42例不可切除的胰腺癌,分为吉西他滨+顺铂(GP组)18例与吉西他滨+替吉奥(GS组)24例。GP组:吉西他滨1000mg/m2,第1,8d,顺铂30mg/d,第4-6d,每3周重复;GS组:吉西他滨1000mg/m2,第1,8d,替吉奥根据体表面积,予80-120mg/d,口服,第1-14d,每3周重复。结果 GS组和GP组总有效率(CR+PR)分别为37.3%和33.3%(P>0.05)。GS组和GP组6个月生存率分别为79.2%和83.3%(P>0.05),1年生存率分别为29.2%和22.2%(P>0.05)。中位无疾病进展时间分别为5.5个月和4.5个月(P<0.05),中位总生存时间分别为8.8个月和8.15个月(P>0.05)。两种方案毒副反应:GP组恶心、呕吐发生率明显高于GS组(83.3%vs 45.8%,P=0.024),差异有统计学意义。结论吉西他滨联合替吉奥或联合顺铂治疗晚期胰腺癌安全有效,在延长生存期方面也显示出一定的优势,但差异无统计学意义。

Objective To evaluate the clinical efficacy of gemcitabine plus S-1 and gemcitabine plus cisplatin in treating of advanced pancreatic cancer. Methods Forty-two advanced pancreatic cancer patients collected from Feb 2010 Dec 2012 in our hospital. All patients were divided into two groups,GP group：gemcitabine plus cisplatin （18 patients） and GS group： gemcitabine plus S-1 （24 patients）. In GP group,patients were given gemcitabine 1000mg·m-2 on the 1st and 8th day,cisplatin d·m-1,repeated every 3 weeks. In GS group,patients were given gemcitabine （usage as well as GP group） and S-1 taken based on the body surface area bid on the 1-14d,repeated every 3 weeks. Results In GS and GP group,objective response was 37.3%and 33.3%（P〉0.05）, CBR was 37.3% and 33.3%（P〉0.05）,the 6-month survival rate was 79.2% and 83.3%（P〉0.05）,the 12-month survival rate was 29.2%and 22.2%（P〉0.05）,respective. The progression-free survival （PFS） was 5.5 months and 4.5 months（P〈0.05）,and the medi-an overall survival was 8.8 months and 8.15 months（P〉0.05）. The incidence of nausea and vomiting of GP group significantly high-er than GS. Conclusion The two kinds of chemotherapy regimens are effective and safe for treating locally advanced or metastatic pancreatic cancer. Gemcitabine plus S-1 is better than plus cisplatin in PFS,it also shows superiority in survival rates,but there is no significant difference bewteen two chemotherapy regimens.