低剂量健择治疗老年晚期胰腺癌的临床观察

Treatment of eldly Advanced Pancreatic Cancer with Low Dose gemcitabine, 5-Fu and Leucovorin

目的 :观察低剂量健择 (GEM) ,氟脲嘧啶 (5 -Fu)与四氢叶酸钙 (CF)三药联合化疗对老年晚期胰腺癌的客观疗效及其临床受益反应 (CBR)。方法 :GEM 1 0 g ,5 -Fu 0 75g ,CF 0 1g ,于第 1、8天滴注 ,2 1天为一周期 ,按WHO标准评价疗效 ,同时综合评估临床受益反应 (CBR)指标 :疼痛、体力状况及体重变化。结果 :全组 15例 ,14例化疗两周期以上 ,其中PR4例 (2 8 6 % ) ,NC 7例 (5 0 % ) ,PC 3例 (2 1 4 % )。参照CBR综合指标 ,CBR率 5 7 1% (8/ 14 )。主要毒性为消化道反应及骨髓抑制 ,其中血小板Ⅲ -Ⅳ度毒性反应为 2 6 7% (4/ 15 )。失访 2例。结论 :健择联合氟脲嘧啶和四氢叶酸钙对老年晚期胰腺癌具有一定的肿瘤客观缓解率 ,临床受益反应率高 。

Objective:To observe the objective effect and clinical benefit response of 15 eldly patients with advanced pancreatic cancer who used a combine of low dose Gemcitabine (GEM), 5 Fu and Leucovorin (CF).Methods:The treatment with Gemcitabine(1.0) was followed by CF(0.1) and 5 Fu(0.75), administered on days 1 and 8 of 21 day schedule. The objective effect was estimated according to the standard of WHO and the clinical benefit response was evaluated at the same time. The standard of CBR included pain, physical states and body weight.Results:Fourteen(14/15) patients received over two cycles chemotherapy. 4(28 6%) partial response (PR). 7(50%) stable disease(SD) and 3(21.4%) progressive disease(PD) was observed. According to the standard of CBR, 8(57.1%) patients achieved the CBR level. The main toxicities included the alimentary tract reactions and the marrow depression. Grade 3～4 thrombocytopenia was reported in 4(26.7%) patients.Conclusion:The combination of low dose GEM, 5 Fu and CF is a moderatedly active treatment with tolerable side effects, it has definite response rate and high CBR rate in pancreatic cancer.