胰腺癌间质化疗临床疗效分析  

Effect of Interstitial Chemotherapy on Pancreatic Cancer

作　　者：李井泉[1] 王世亮[2] 丁满志[2] 陈殿良[2] 祝牡丹[2] 蒲永东[1] 

机构地区：[1]中国人民解放军第三〇九医院普通外科,北京市100091 [2]合肥工业大学医学工程学院控释药物研究室

出　　处：《中国全科医学》2012年第32期3789-3791,共3页Chinese General Practice

摘　　要：目的探讨氟尿嘧啶缓释制剂间质化疗治疗进展期胰腺癌的效果。方法选取2009年1月—2012年6月我院收治的71例经剖腹探查且行术中穿刺细胞学检查证实为不可切除的胰腺癌患者,随机分为间质化疗组(33例)和对照组(38例)。间质化疗组瘤内植入氟尿嘧啶缓释制剂,有胆、肠梗阻时行内引流术;对照组仅行剖腹探查,有胆、肠梗阻时行内引流术。以临床受益反应〔包括疼痛(视觉模拟评分法评分,VAS评分)、全身状况(全身状况评分,KPS)、体质量〕及生存状况为观察指标进行分析比较。结果治疗前间质化疗组患者VAS评分、KPS及体质量与对照组比较,差异均无统计学意义(t值分别为0.8、3.4、3.6,P>0.05);治疗后间质化疗组VAS评分及KPS与对照组比较,差异有统计学意义(t值分别为15.5、59.7,P<0.05),而体质量比较差异无统计学意义(t=3.8,P>0.05)。间质化疗组随访1.0～19.5个月,33例患者中29例死亡,4例存活;对照组随访1.0～16.0个月,38例患者均死亡。间质化疗组中位生存时间为8.4个月,对照组为4.0个月。间质化疗组和对照组6个月的生存率分别为63.6%(21/33)和31.6%(12/38);12个月的生存率分别为21.2%(7/33)和5.3%(2/38)。两组患者生存曲线比较,差异有统计学意义(χ2=5.24,P<0.05)。结论氟尿嘧啶缓释制剂间质化疗能够有效改善胰腺癌患者的生存状况,延长患者的生存时间,可以作为不可切除胰腺癌的治疗手段。Objective To study the effectiveness of interstitial chemotherapy of slow-release fluorouracil preparation in treatment of pancreatic cancer.Methods Seventy-one patients with advanced unresectable pancreatic cancer verified through surgical exploration and cytological examination from January 2009 to June 2012 were divided randomly into groups ICT（interstitial chemotherapy group,n=33） and control（n=38）.Group ICT were treated with slow-release fluorouracil preparation during operation,a drainage procedure was implemented when bile duct or intestine obstruction occurred,control group underwent exploratory laparotomy only or a drainage procedure when bile duct or intestine obstruction occurred.Clinical benefit response including pain（visual analogue scale,VAS）,general condition（karnofsky performance score,KPS）,weight changes and survival status were observed.Results There were not significant differences in VAS,KPS and body mass between 2 groups before treatment,respectively（t= 0.8,3.4,3.6,P0.05）,but after treatment there were in VAS and KPS（t=15.5,59.7,P0.05）,not in body mass（t=3.8,P0.05）.In ICT group follow-up lasted 1.0~19.5 months,29 patients died,4 survived,the mean survival time was 8.4 months;In control group follow-up lasted 1.0~16.0 months,38 patients died,The mean survival time was 4.0 months.The 6-month survival rates of groups ICT and control were 63.6%（21/33）,31.6%（12/38）,respectively;The 12-month survival rates were 21.2%（7/33）,5.3%（2/38）,respectively.There was significant difference in survival curve between 2 groups（χ2=5.24,P0.05）.Conclusion Interstitial chemotherapy with slow-release fluorouracil preparation,improving effectively survival status and prolonging survival time of pancreatic cancer patients,can be used as an important treatment of unresectable pancreatic cancer.

关 键 词：胰腺肿瘤 氟尿嘧啶 迟效制剂 间质化疗 临床受益反应 生存状况 

分 类 号：R735.9[医药卫生—肿瘤]