维拉帕米联合化疗药物介入治疗中晚期胰腺癌的疗效研究

Efficacy of verapamil combined with chemotherapeutic agents in interventional therapy of advanced stage of pancreatic cancer

[目的]研究靶动脉灌注维拉帕米联合化疗药物对中晚期胰腺癌的疗效。[方法]以2012年1月~2016年12月收治于我院的中晚期胰腺癌患者68例为研究对象,随机分为对照组35例和观察组33例。对照组为靶动脉单纯灌注化疗药物,观察组使用靶动脉灌注维拉帕米联合化疗药物。每例至少介入2次以上,介入治疗2次后评估2组的有效率为完全缓解+部分缓解(CR+PR)、临床获益、药物的毒副反应及心血管毒性,随访生存期。[结果]①胰腺癌原发病灶:对照组有效率(CR+PR)%为48.5%,其中CR为0%,PR为48.5%;观察组有效率(CR+PR)%为69.6%,其中CR为0,PR为69.6%。②肝脏转移性病灶:对照组有效率(CR+PR)为52%,其中CR为0%,PR为52.0%;观察组有效率(CR+PR)为73.9%,其中CR为0,PR为73.9%,观察组疗效明显好于对照组。③临床受益评估:对照组KPS评分临床受益阳性20例,疼痛临床受益阳性13例,体重临床受益阳性12例;观察组KPS评分临床受益阳性25例,疼痛临床受益阳性24例,体重临床受益阳性20例,观察组临床获益明显优于对照组。④生存分析:对照组和观察组的中位PFS为6个月和11个月,中位OS为9个月和15个月,观察组的中位PFS和中位OS较对照组均明显延长,差异有统计学意义(P<0.01)。⑤观察组所有患者均未出现严重不良反应,心功能及心电图在治疗前后亦均无明显变化。[结论]维拉帕米联合化疗药物介入治疗中晚期胰腺癌明显提高化疗的疗效,延长并提高了患者的生存期和生活质量,且未增加患者的药物不良反应。

[Objective]To evaluate the efficacy of target artery infusion of verapamil combined with chemotherapy in interventional therapy of advanced stage of pancreatic cancer.[Methods]68 patients with advanced pancreatic cancer admitted to our department from January 2012 to December 2016 were enrolled in the study.In addition,these 68 patients were randomly divided into control group(n=35),treated by target artery infusion of chemotherapy,and observation group(n=33)treated by target artery infusion of verapamil combined with chemotherapy.Every patient was at least treated twice and then evaluate the total effectiveness rate(complete remission(CR)and partial remission(PR),CR+PR),clinical profit,drug toxicity and cardiovascular toxicity of two groups with overall survival(OS)rate followed up.[Results]①Primary lesion of pancreatic carcinoma:the total effectiveness rate(CR+PR)in the control group was 48.5%(among them CR is 0%,PR is 48.5%)and the rate in the observation group was 69.6%(among them CR is 0%,PR is 69.6%).②Liver metastatic lesion:the total effectiveness rate(CR+PR)in the control group was 52%(among them CR is 0,PR is 52%),however,73% in the observation group(among them CR is 0%,PR is 73%).It is obviously that the rate in the observation group is better than that in the control group.③Clinical profit:In the control group,KPS scores were positive in 20 cases,positive with pain in 13 cases and with weight gain in 12 cases,respectively.On the contrast,In the observation group,KPS scores were positive in 25 cases,with pain in 24 cases and with weight gain in 20 cases,respectively.The clinical profit of the observation group is significantly better than those of the control group.④Overall survival(OS)rate:The median PFS of the control group and the observation group were 6 months and 11 months.The median OS were 9 months and 15 months,respectively.The median PFS and median OS in the observation group are significantly longer than those in the control group with significant statistical difference(P<0.01).⑤There were no serious adverse reactions in all the patients in the observation group,and there were no significant changes in cardiac function and ECG after treatments.[Conclusion]Verapamil combined with chemotherapeutic agents can significantly improve the efficacy of chemotherapy,prolongs and improves the survival time and quality of life of patients with advanced pancreatic cancer with no more adverse effect.