74例胰腺癌的治疗策略及生存分析  

Treatment strategies and survival analysis of 74 cases pancreatic cancer

作　　者：赵翌[1] 刘建[1] 张娜[1] 田源[1] 

机构地区：[1]大连医科大学附属第一医院肿瘤科,116011

出　　处：《中国医师进修杂志》2012年第12期15-18,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的通过分析胰腺癌患者临床特点及生存情况，探索最佳治疗方案。方法收集经病理（手术病理或穿刺活检）诊断或临床（影像学＋肿瘤标志物CA19．9）诊断的74例胰腺癌患者的临床资料；根据治疗方法不同分为五组进行比较：单纯手术组11例、术后化疗组20例、姑息化疗组13例、姑息放疗组13例、未行治疗组17例。对五组患者的临床特点及总生存时间进行分析。结果术后化疗组患者的中位总生存时间（300d）优于未行治疗组（119d），差异有统计学意义（P〈0．01）；而单纯手术组、姑息化疗组、姑息放疗组与未行治疗组中位总生存时间比较差异无统计学意义（120、164．109d比119d，P〉0．05）。胰腺癌晚期常出现腹痛、黄疸、恶心呕吐、消瘦等伴随症状，其中接受手术患者与非手术患者相比，黄疸的发生率较低[19．35％（6／31）比37．21％（16／43）]，但是差异无统计学意义（r=2．75，P=0．10）；接受放疗患者与非放疗患者相比，腹痛的发生率较低[23．08％（3／13）比68．85％（42／61）]，差异有统计学意义（r=12．59，P=0．00）。胰腺癌患者腹水的发生率达75．68％（56／74），总生存时间缩短，未行治疗组出现腹水的危险度最高。结论手术联合化疗可提高胰腺癌患者总生存时间，是胰腺癌治疗的较好选择；放疗使腹痛明显减轻；治疗过程中出现腹水是预后不佳的信号。Objective To explore the best treatment method for patients with pancreatic cancer by analyzing the clinical and survival features. Methods The clinical data of 74 patients with pancreatic cancer diagnosed by pathology diagnosis （surgical pathology or biopsy） or clinical diagnosis （imaging ＋ tumor marker CA19-9） were collected. The cases were divided into 5 groups according to different therapy methods：surgery alone group （11 cases）, postoperative chemotherapy group （20 cases）, palliative chemotherapy group （ 13 cases）, palliative radiotherapy group （ 13 cases）, untreated group （ 17 cases）. The clinical features and overall survival time of patients with pancreatic cancer were analyzed. Results The median overall survival time of postoperative chemotherapy group was longer than that of untreated group （300 d vs. 119 d, P 〈 0.01 ） ; The median overall survival time of surgery alone group, palliative chemotherapy and palliative radiotherapy group had no significant difference compared with that of untreated group （120, 164, 109 d vs. 119 d, P 〉 0.05 ）. The patients with advanced pancreatic cancer often suffered from abdominal pain, jaundice, nausea, vomiting, weight loss and other associated symptoms. The incidence of jaundice of patients undergoing surgery was lower compared with non-surgical patients, but the difference was not significant [ 19.35% （6/31 ） vs. 37.21% （ 16/43 ）, X2 = 2.75, P = 0. 10 ]. The incidence of abdominal pain of patients with radiotherapy was lower than that of non-radiotherapy patients [23.08% （3/13） vs. 68.85% （42/61）, X2 = 12.59 ,P = 0.00]. The ascites incidence rate was 75.68%（56/74） which shortened the overall survival time,and untreated group had the highest risk rate of ascites. Conclusions Operation combined with chemotherapy is a better treatment that can improve the overall survival time of patients with pancreatic cancer. Radiotherapy can obviously relieve the abdominal pain. Aseites is a signal of poor prognosis du

关 键 词：胰腺肿瘤 治疗 生存分析 

分 类 号：R735.9[医药卫生—肿瘤]