白蛋白结合型紫杉醇联合吉西他滨一线治疗晚期胰腺癌的疗效观察

Study on the efficacy of albumin-binding Taxol combined with gemcitabine in treatment of patients with advanced pancreatic cancer

目的 探讨白蛋白结合型紫杉醇联合吉西他滨一线治疗晚期胰腺癌的临床效果。方法 采用前瞻性研究方法,选取2015年8月至2018年8月海安市人民医院收治的60例晚期胰腺癌患者,按照随机数字表法将患者分为试验组与对照组,每组各30例。对照组患者给予单药吉西他滨治疗,试验组患者给予白蛋白结合型紫杉醇联合吉西他滨一线治疗方案。比较两组患者的临床疗效、生存情况及主要不良反应。结果 试验组患者的临床总有效率为66. 67%,显著高于对照组的30. 00%,差异具有统计学意义(P <0. 05);试验组患者中位生存期(10. 81±2. 16个月vs.7. 32±1. 95个月)、无进展生存期为(3. 90±0. 95个月vs. 2. 62±0. 55个月)、半年内生存率(71. 44%±8. 93%vs.58. 41%±7. 22%)均显著优于对照组,差异具有统计学意义(P <0. 05);试验组与对照组患者的白细胞减少(70. 00%vs. 66. 67%)、肾毒性(70. 00%vs. 73. 33%)、血小板减少(23. 33%vs. 30. 00%)等不良反应发生率差异均无统计学意义(P> 0. 05)。结论 白蛋白结合型紫杉醇联合吉西他滨一线治疗晚期胰腺癌,有效率高,效果安全,明显延长了患者生存期,具有一定的应用价值。

Objective To explore the clinical effect of albumin-bound paclitaxel combined with gemcitabine in treatment of patients with advanced pancreatic cancer.Methods By using prospective study method,60 patients with advanced pancreatic cancer admitted to Hai'an People's Hospital during August 2015 to August 2018 were enrolled.These patients were divided into trial group and control group according to random number table method,30 cases in each group.Patients in control group were treated with single-agent gemcitabine,and patients in trial group were given with first-line treatment including albumin-bound paclitaxel plus gemcitabine.In comparison with those of clinical efficacy,survival period and major adverse reactions in these two groups of patients.Results The total clinical effective rate of trial group was 66.67%,which was significantly higher than that of control group(30.00%),and the difference was statistically significant(P<0.05).The median survival period of trial group and control group were(10.81±2.16 vs.7.32±1.95)months,the progression-free survival period was(3.90±0.95 vs.2.62±0.55)months,and the survival rate within half a year was(71.44±8.93 vs.58.41±7.22)%,which was significantly better than that of control group.The difference was statistically significant.(P<0.05);the incidence of adverse reactions such as leukopenia(70.00%vs.66.67%),nephrotoxicity(70.00%vs.73.33%),thrombocytopenia(23.33%vs.30.00%)in trial group and control group,and there was no significant difference(P>0.05).Conclusion The application of albumin-binding paclitaxel and gemcitabine for the first-line treatment in patients with advanced pancreatic cancer is safe and effective,hence it can significantly prolong the survival period of these patients,hence it has certain value for application.