吉西他滨对进展期胰腺癌的治疗作用  

Therapeutic effects of gemcitabine on advancing pancreatic carcinoma

作　　者：吕平[1] 王春友[1] 熊炯炘[1] 刘芳[2] 周峰[1] 陈立波[1] 润晓勤[1] 赵刚[1] 王帆[3] 

机构地区：[1]华中科技大学同济医学院附属协和医院胰腺外科中心,武汉市430022 [2]华中科技大学同济医学院附属协和医院放射科CT室,武汉市430022 [3]华中科技大学同济医学院附属协和医院检验科,武汉市430022

出　　处：《中华肝胆外科杂志》2004年第4期238-241,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　评价吉西他滨 (gemcitabine)对局部进展和转移胰腺癌病人的临床疗效。 方法　2 7位入选病人 (7人曾接受氟尿嘧啶化疗 )接受gemcitabine化疗 ,用量 75 0mg/m2 ,经外周静脉滴入或经动脉化疗泵注入。每周 1次× 3周 ,休 1周 ,重复进行。观察病人肿瘤治疗反应、生存时间、临床受益反应及毒副作用等。结果　 (1)无完全反应者 ,部分反应 6人 [反应率 2 2 % ;中位持续时间为 4 9个月 (2 0～ 7 8个月 ) ],疾病稳定 11人 [中位持续时间为 5个月 (3 0～ 8 2个月 ) ],疾病进展 10人 ,全组中位至疾病进展时间为 4个月 (0 5～ 10 8个月 ) ;(2 )中位生存时间为 6 3个月 (1 1～ 13 3个月 ) ,6个月累积生存率为 5 8% ;(3) 12位病人获得临床受益反应 ,占全部病人的 4 4 % ;(4 )以血液系统毒副反应较常见 ,但多为WHOⅠ～Ⅱ级 ,未出现WHOⅣ级毒副作用。结论　Gemcitabine对于初治或氟尿嘧啶化疗无效的进展期胰腺癌病人均显示出较好的治疗效果 ,并能改善病人疾病相关症状。毒副作用相对较轻。Objective To investigate the therapeutic effects of gemcitabine on advancing pancreatic carcinoma. Methods A total of 27 patients (7 of them had once received chemotherapy using 5-Fluorouracil) underwent chemotherapy by intravenous dripping or intraarterial pumping of gemcitabine at a dosage of 750 mg/m2,once a week ×3 weeks followed by 1-week rest in one cycle. The treatment was repeated. Tumor response,survival time,clinical beneficial response (CBR) and toxicity were determined in all the patients. Results 1) No patient achieved a complete response and only 6 achieved the partial response [response rate = 22%,median duration = 4.9 months (2.0-7.8 months)]. Eleven patients had stable disease in a median duration of 5 months (3.0-8.2 months) and 10 experienced progressive disease. The median time for progression in all the patients was 4 months (0.5-10.8 months). 2) The median survival time was 6.3 months (1.1-13.3 months). The cumulative survival rate in 6 months was 58%. 3) Twelve patients (44%) had CBR. 4) The most common toxicity was hematological. However,the toxicity in most of the patients was grade I-II according to WHO classification. There was no grade IV toxicity. Conclusions Gemcitabine has strong therapeutic effects on advancing pancreatic carcinoma no matter the patients are treated for the first time or receive treatment with 5-Fluorouracil before. It can also improve the tumor-related symptoms and its toxicity is relatively mild.

关 键 词：病人 胰腺癌 吉西他滨 毒副作用 疾病进展 临床受益反应 进展期 累积 生存时间 局部 

分 类 号：R735.9[医药卫生—肿瘤] R734[医药卫生—临床医学]