局部进展期/转移性胰腺癌一线含吉西他滨化疗进展后的临床分析  

Clinical analysis of locally advanced/metastatic pancreatic cancer after progression of gemcitabine-based first-line chemotherapy

作　　者：尹文琤[1] 张华[2] 于金玉 曹宝山[1] YIN Wen-cheng;ZHANG Hua;YU Jin-yu;CAO Bao-shan(Department of Medical Oncology and Radiation Sickness,Peking University Third Hospital,Beijing 100191,China;Research Center of Clinical Epidemiology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院肿瘤化疗与放射病科,北京100191 [2]北京大学第三医院临床流行病学研究中心,北京100191

出　　处：《中国临床药理学杂志》2022年第3期207-210,214,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的分析局部进展期/转移性胰腺癌患者一线含吉西他滨化疗进展后的后续治疗模式及一线化疗进展后的预后因素。方法回顾性分析局部进展期/转移性胰腺癌患者一线使用含吉西他滨化疗进展后的临床特征、后续治疗方法、方案、疗效及生存期,用卡方检验进行组间比较,用Kaplan-Meier法进行单因素生存分析,用COX比例风险回归模型进行多因素分析。结果共纳入91例患者,其中32例(35.16%)患者一线化疗进展后仅行最佳支持治疗,59例(64.84%)患者继续行后线化疗。一线化疗最佳疗效为稳定或中位无进展生存期在91~180 d的患者继续后线化疗的比例低。84例患者一线化疗进展后中位生存期是151 d;序贯化疗和序贯最佳支持治疗的患者一线化疗进展后中位生存期分别为182和83 d,差异有统计学意义(P <0.01)。多因素分析显示:一线化疗进展后有无腹腔转移、二线化疗疗效和化疗线数是后续化疗组患者一线化疗进展后中位生存期的独立预后因素。结论一线化疗的疗效影响局部进展期/转移性胰腺癌患者后续治疗的模式,一线化疗进展后继续后线化疗的患者生存期更长,继续化疗的患者中无腹腔转移、二线最佳疗效为部分缓解、接受≥三线化疗者预后更好。Objective To analyze the follow-up treatment modes and prognostic factors after the progression of gemcitabine-based first-line chemotherapy in patients with locally advanced/metastatic pancreatic cancer. Methods The clinical characteristics,follow-up treatment methods,regimens,therapeutic efficacy and survival of patients with locally advanced/metastatic pancreatic cancer after progression of gemcitabine-based first-line chemotherapy were retrospectively analyzed. Chi-square test was performed for comparison between groups. Kaplan-Meier method was performed for univariate survival analysis, and COX proportional hazard model was performed for multivariate analysis. Results advanced/metastatic pancreatic cancer eligible in this study,32 patients( 35. 16%) received only the best supportive care after progression of first-line chemotherapy,and 59 patients( 64. 84%) received follow-up chemotherapy. The proportion of patients with stable disease as the best response or with median progression-free survival ranging from 91 to 180 days of first-line chemotherapy receiving follow-up chemotherapy was low. The median survival of the 84 patients progressing with first-line chemotherapy was 151 days. The median survival of patients who received follow-up chemotherapy and the best supportive care were 182 days and 83 days respectively,and the difference was statistically significant( P < 0. 01). Multivariate analysis showed that the presence or absence of abdominal cavity metastasis after the progression of first-line chemotherapy,the efficacy of second-line chemotherapy,and the number of chemotherapy lines were independent prognostic factors for the median survival of patients in the sequential chemotherapy group after progression with first-line chemotherapy. Conclusion chemotherapy affected the follow-up treatment modes for patients with locally advanced/metastatic pancreatic cancer.Patients who received follow-up chemotherapy after progression with first-line chemotherapy harbored a longer survival. Patients without abdom

关 键 词：吉西他滨 胰腺癌 后续治疗 生存期 

分 类 号：R979.1[医药卫生—药品]