抑癌散结汤联合缓释氟尿嘧啶治疗胰腺癌的疗效

Efficacy evaluation of Yiaisanjie soup combined with sustained release fluorouracil in the treatment of pancreatic cancer

目的观察中药抑癌散结汤联合缓释氟尿嘧啶植入治疗胰腺癌的疗效和不良反应。方法回顾性分析2012年1月至2015年12月间浙江省湖州市德清县人民医院诊治的62例胰腺癌患者的临床资料，分为联合治疗组及对照组。联合治疗组患者在CT引导穿刺下将10颗氟尿嘧啶缓释粒子植入瘤体，术后1d服用抑癌散结汤，每日1剂，服3周停1周，持续至少6个周期。对照组患者仅给予缓释氟尿嘧啶植入治疗。抽取术前及术后1周内的空腹血，检测血清肿瘤标志物；记录患者的不良反应；根据实体瘤的疗效评价标准（RECIST）评价治疗效果。结果治疗前两组患者血清CEA、CA125、CA242、CA19-9、CAS0的水平差异均无统计学意义；治疗后两组患者血清肿瘤标志物水平均较治疗前显著下降，其中联合治疗组的下降程度显著高于对照组，差异均有统计学意义（P值均〈0．05）。联合治疗组的Ⅱ＋Ⅲ度血小板减少、恶心呕吐、腹泻发生率均显著低于对照组（12．12％比34．48％，18．18％比48．28％，9．09％比41．38％，P值均〈0．05）。33例联合治疗组患者中部分缓解（PR）10例，稳定（SD）17例，进展（PD）6例，总有效率81．8％；29例对照组患者中PR5例，SD15例，PD9例，总有效率69．0％。两组疗效的差异无统计学意义（）（2=1．390，P=0．119）。结论中药抑癌散结汤联合缓释氟尿嘧啶植入治疗胰腺癌疗效不明显，但可以显著降低血清肿瘤标志物水平、减少不良反应发生率。

Objective To investigate the effects and adverse events of Yiaisanjie soup combined with sustained release fluorouraeil in treating pancreatic cancer. Methods From January 2012 to December 2015, the clinical data of 62 cases with pancreatic cancer in Deqing County People＇s Hospital were retrospectively analyzed , which were divided into combination group and control group. The combination group underwent the implantation of sustained release fluorouracil particles under CT guidance and took Yiaisanjie soup once a day for at least 5 cycles of 3-week administration and then 1-week no administration. The control group was treated only by sustained fluorouracil particle implantations. The blood samples at fasting were collected before and 1 week after treatment to detect serum tumor markers. The adverse events were recorded. The therapeutic effect for solid tumors was evaluated according to response evaluation criteria in solid tumors（RECIST）. Results Before treatment, CEA, CA125, CA242, CA19-9 in 2 groups had no statistical differences. After treatment, these tumor markers obviously decreased in both groups compared with before treatment. Compared with the control group, the CEA, CA125, CA242, CAS0 and CA19-9 in combination group decreased at a more significant degree, and the difference was statistical significant （ P 〈 O. 05 ）. The incidence of Ⅱ and Ⅲ degree thrombocytopenia, nausea, vomiting and diarrhea was significantly lower in the combination group than in the control group （12.12% vs 34.48%, 18.18% vs 48.28% , 9.09% vs 41.38% , all P〈0.05）. There were10 cases with partial remission （PR）, 17 cases with stable disease （SD） and 6 cases with progressive disease （PD）, and the total effective rate was 81.8% （27/33） in the combination group. There were 5 cases with PR, 15 cases with SD and 9 cases and PD, and the total effective rate was 69.0% （20/29） in the control group. The difference was not statistically significant （ X2 = 1. 390, P = 0.119）. Conclusions The therapeutic effect of Yiaisanjie soup combined with sustained release fluorouracil in treatment of pancreatic cancer is not obvious, but the combination can significantly reduce serum tumor markers and reduce the incidence of side effects.