白蛋白结合型紫杉醇联合吉西他滨治疗晚期转移性胰腺癌的疗效和安全性

Efficacy and safety of albumin-bound paclitaxel combined with gemcitabine in the treatment of advanced and metastatic pancreatic cancer

目的探讨传统AG方案[吉西他滨(1000 mg/m^(2),d1、d8)+白蛋白结合型紫杉醇(125 mg/m^(2),d1、d8),21 d为1个周期]与吉西他滨为主的其他方案(吉西他滨单药/联合替吉奥/联合奥沙利铂/联合安罗替尼)治疗晚期转移性胰腺癌的疗效及安全性。方法回顾性收集2017年1月至2022年1月南京医科大学附属逸夫医院晚期转移性胰腺癌64例患者的临床资料,接受传统AG方案治疗的患者33例,接受以吉西他滨为主的化疗方案患者31例,根据随访数据进行生存分析,研究终点为总生存期(OS)和无进展生存期(PFS),次要研究终点为3/4级不良反应发生率。结果AG方案组和吉西他滨组中位OS分别为12.2个月和7.9个月,差异无统计学意义(χ^(2)=1.517,P=0.218)。AG方案组和吉西他滨组中位PFS分别为7.0个月和3.3个月(χ^(2)=8.683,P=0.003)。两组患者3/4级不良反应事件发生率差异无统计学意义(P>0.05)。结论晚期胰腺癌患者选择白蛋白结合型紫杉醇联合吉西他滨方案一线治疗具有显著的临床效果,明显控制了疾病进展,延长了患者的PFS。

Objective To investigate the efficacy and safety of traditional AG regimen[gemcitabine(1000 mg/m^(2),d1,d8)+albumin-bound paclitaxel(125 mg/m^(2),d1,d8),21 days as a cycle]and other gemcitabine-based regimen[gemcitabine alone or combined with S-1(tegafur,gimeracil and oteracil potassium)/oxaliplatin/arotinib]in the treatment of advanced and metastatic pancreatic cancer.Methods From January 2017 to January 2022,64 patients with advanced and metastatic pancreatic cancer were retrospectively collected from Sir Run Run Hospital of Nanjing Medical University.There were 33 patients received traditional AG therapy and 31 patients received chemotherapy mainly with gemcitabine.Survival analysis was conducted based on follow-up data,with the study endpoints being overall survival(OS)and progression free survival(PFS),and the secondary study endpoint being the incidence of grade 3/4 adverse reactions.Results The median OS of the AG regimen group and the gemcitabine group were 12.2 months and 7.9 months,respectively,and there was no significant difference between two groups(χ^(2)=1.517,P=0.218).The median PFS of the AG regimen group and the gemcitabine group was 7.0 months and 3.3 months,respectively(χ^(2)=8.683,P=0.003).There was no significant difference in the incidence of grade 3/4 adverse events between the two groups of patients(P>0.05).Conclusion The first-line treatment of albumin-bound paclitaxel combined with gemcitabine in patients with advanced pancreatic cancer has significant clinical effects,which significantly controls the disease progress and extends the PFS of patients.