替吉奥单药治疗胆管细胞癌根治术患者的临床疗效  

Effects of S-1 single agent chemotherapy in the radical resection of cholangiocarcinoma

作　　者：徐永子 白雪莉[1] 陈伟[1] 高顺良[1] 楼健颖[1] 曹春辉[1] 梁廷波[1] 

机构地区：[1]浙江大学医学院附属第二医院肝胆胰外科,杭州310009

出　　处：《中华消化外科杂志》2015年第4期294-297,共4页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金面上项目（81171884）

摘　　要：目的 探讨替吉奥单药治疗胆管细胞癌根治术患者的临床疗效.方法 回顾性分析2011年11月至2013年12月浙江大学医学院附属第二医院收治的51例行胆管细胞癌根治术患者的临床资料.25例患者术后未行化疗,设为未化疗组;26例患者术后行替吉奥单药化疗,设为化疗组.未化疗组患者行胆管细胞癌根治术后无特殊处理.化疗组患者术后给予替吉奥单药化疗,用法：口服,2次/d,分别为早、晚餐后;用量：体表面积＜1.25 m^2的患者为40 mg/次,1.25 m^2≤体表面积＜ 1.50 m^2的患者为50 mg/次,体表面积≥1.50 m^2的患者为60 mg/次.连续用药14 d后停药7d,为1个疗程.常规给予6～8个疗程.采用门诊和电话方式进行随访,随访时间截至2014年12月1日.计数资料比较采用x2检验.符合正态分布的计量资料以x^-±s表示,采用t检验进行比较.采用Kaplan-Meier法绘制生存曲线,Log-rank检验进行生存分析.结果 化疗组26例患者均完成化疗疗程,无化疗相关死亡患者.14例患者出现化疗不良反应,停药后均明显缓解.51例患者均获得随访,随访时间为5～37个月,中位随访时间为19个月.未化疗组患者总体中位生存时间为22个月（18～27个月）,1、3年总体生存率分别为72.3％和42.9％;无瘤中位生存时间为21个月（16 ～ 26个月）,1、3年无瘤生存率分别为60.0％和55.0％.化疗组患者总体中位生存时间为32个月（29 ～ 35个月）,1、3年总体生存率分别为84.6％和44.4％;无瘤中位生存时间为26个月（21 ～31个月）,1、3年无瘤生存率分别为76.9％和61.9％.两组患者总体生存情况比较,差异有统计学意义（x2=6.032,P＜0.05）;两组患者无瘤生存情况比较,差异无统计学意义（x2=0.498,P＞0.05）.结论 胆管细胞癌患者行根治术后给予替吉奥化疗,能取得明显的生存获益,但在抑制胆管细胞癌复发方面,无明显优势.Objective To explore the clinical effects of S-1 single agent chemotherapy for the patients undergoing radical resection of cholangiocarcinoma.Methods The clinical data of 51 patients receiving radical resection of cholangiocarcinoma who were admitted to the Second Affiliated Hospital of Zhejiang University from November 2011 to December 2013 were retrospectively analyzed.After radical resection of cholangiocarcinoma,25 patients receiving non-special treatment and 26 patients receiving S-1 single agent chemotherapy were divided into the operation group and chemotherapy group,respectively.S-1 was taken orally twice per day.Forty mg/once of S-1 was applied to patients with the body surface area 〈 1.25 m^2,50 mg/once of S-1 was applied to patients with the body surface area ≥ 1.25 m^2 and 〈 1.50 m^2,and 60 mg/once of S-1 was applied to patients with the body surface area ≥ 1.50 m^2.The 14 days usage and 7 days withdrawal of S-1 were used as one course of treatment.The standard usage of S-1 was 6-8 courses of treatment.All the patients were followed up by outpatient examination and telephone interview till December 1,2014.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as x^- ± s and analyzed using the t test.Survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results Twenty-six patients in the chemotherapy group finished the courses of chemotherapy without chemotherapy-related death,and 14 patients had chemotherapy adverse reactions with remission after discontinuation of S-1.All the 51 patients were followed up for 5-37 months with a median time of 19 months.The median overall survival time,1-,3-year overall survival rates,tumor-free median survival time and 1-,3-year tumor-free survival rates were 22 months （range,18-27 months）,72.3%,42.9%,21 months （range,16-26 months）,60.0%,55.0% in the operation group and 32 months （range,29-35 months）,84.6%,44.4%,26 months （range,21-31 month

关 键 词：胆管细胞癌 根治术 替吉奥 化疗 

分 类 号：R735.8[医药卫生—肿瘤]