盐酸吉西他滨联合立体定向放疗治疗局部晚期胰腺癌的效果评价

Therapeutic effect of gemcitabine hydrochloride combined with stereotactic radiotherapy for locally advanced pancre-atic cancer

目的评价盐酸吉西他滨联合立体定向放疗治疗局部晚期胰腺癌的临床疗效。方法收集2008年6月-2013年6月福州总医院收治的初治无法手术切除的局部晚期胰腺癌患者122例,按治疗方法分为盐酸吉西他滨联合立体定向放疗治疗(A组,n=56)和吉西他滨单药治疗(B组,n=66)。记录治疗后患者病情变化情况、毒副反应及死亡时间。计数资料组间比较采用χ2检验,采用Kaplan-Meier法绘制生存曲线。结果 A组治疗后有效率67.8%(38/56),B组治疗后有效率22.7%(15/66),2组比较差异有统计学意义(χ2=25.11,P<0.01);A组止痛有效率95.8%,B组止痛有效率77.2%,2组比较差异有统计学意义(χ2=7.39,P<0.01);A组1年生存率58.9%(33/56),2年生存率28.6%(16/96),中位生存时间12.8个月,B组1年生存率31.8%(21/66),2年生存率10.6%(7/66),中位生存时间7.9个月,两组比较差异均有统计学意义(χ2分别为9.03、6.39、15.51,P值均<0.01)。结论盐酸吉西他滨联合立体定向放疗具有较好的近远期疗效,毒副反应能够耐受。

Objective To investigate the clinical therapeutic effect of gemcitabine hydrochloride combined with stereotactic radiotherapy for locally advanced pancreatic cancer. Methods A total of 122 previously untreated patients with locally advanced pancreatic cancer who were not able to undergo surgical resection and were admitted to Fuzhou General Hospital from June 2008 to June 2013 were selected,and according to the therapies,they were divided into the group with a combination of gemcitabine hydrochloride and stereotactic radiotherapy（ group A,n = 56） and the group with gemcitabine therapy alone（ group B,n = 66）. The changes in condition,toxic and side effects,and death time were recorded. The chi- square test was applied for comparison between groups,and the Kaplan- Meier method was applied for plotting survival curves. Results There was a significant difference in response rate between group A and group B [67. 8%（ 38 /56） vs22. 7%（ 15 /66）,χ2= 25. 11,P 〈 0. 01]; the effective pain- relieving rate showed a significant difference between group A and group B（ 95. 8% vs 77. 2%,χ2= 7. 39,P 〈 0. 01）; there were significant differences in 1- year survival rate,2- year survival rate,and median survival time between the two groups [58. 9%（ 33 /56） vs 31. 8%（ 21 /66）,χ2= 9. 03,P 〈 0. 01; 28. 6%（ 16 /56） vs 10. 6%（ 7 /66）,χ2= 6. 39,P 〈 0. 01; 12. 8 months vs 7. 9 months; χ2= 15. 51,P 〈 0. 01]. Conclusion Gemcitabine hydrochloride combined with stereotactic radiotherapy has good short- and long- term efficacy,and toxic and side effects are tolerable.