探讨吉西他滨联合顺铂新辅助化疗治疗可切除胆囊癌的临床效果  

Exploring the clinical effect of gemcitabine combined with cisplatin as neoadjuvant chemotherapy in the treatment of resectable gallbladder cancer

作　　者：蒋春雷 徐永子 孙岩[2] 李晟[2] 王丽君[2] 卢有胜[2] JIANG Chunlei;XU Yongzi;SUN Yan;LI Sheng;WANG Lijun;LU Yousheng(The People s Hospital of Yizheng,Yizheng 211400,China;The Affiliated Cancer Hospital to Nanjing Medical University,Jiangsu Cancer Hospital,Nanjing 210029,China)

机构地区：[1]仪征市人民医院,江苏仪征211400 [2]南京医科大学附属肿瘤医院,江苏省肿瘤医院,江苏南京210029

出　　处：《东南大学学报（医学版）》2024年第6期951-956,共6页Journal of Southeast University(Medical Science Edition)

摘　　要：目的:探讨吉西他滨联合顺铂的新辅助化疗(NACT)方案对可切除胆囊癌(GBC)患者的治疗效果。方法:回顾性分析通过穿刺活检或腹腔镜引导下的组织学或细胞学检查确诊为GBC的59例患者数据,将接受吉西他滨联合顺铂进行NACT治疗的列为NACT组(26例),未进行NACT治疗的列为No-NACT组(33例),对比两组患者入院和术后1周肿瘤预测因子水平、手术结果及随访总生存期(OS)和无进展生存期(PFS)。结果:术后1周,NACT组患者平均糖类抗原19-9(CA19-9)水平和中性粒细胞/淋巴细胞值(NLR)均显著低于No-NACT组患者(P<0.05)。术后NACT组与No-NACT组患者比并发症发生率(19.23%vs 24.24%)和R0切除率(92.31%vs 72.73%)差异均无统计学意义(P>0.05)。NACT组手术切除肿瘤大小<3 cm的患者占53.85%,显著少于No-NACT组的24.24%(P<0.05)。NACT组患者OS和PFS均显著长于No-NACT组(P<0.05)。结论:吉西他滨联合顺铂的NACT治疗方案可降低GBC患者肿瘤不良预测因子水平,延长患者的OS和PFS,改善患者的预后,安全性高。Objective:To investigate the therapeutic effect of the gemcitabine combined with cisplatin as a neoadjuvant chemotherapy(NACT)regimen in patients with resectable gallbladder cancer(GBC).Methods:A retrospective analysis was conducted on the data of 59 patients diagnosed with GBC through histological or cytological examination via biopsy or laparoscopic guidance.Patients who received gemcitabine combined with cisplatin as NACT were classified as the NACT group(26 cases),while those who did not receive NACT were classified as the No-NACT group(33 cases).Tumor prognostic factor levels at admission and one week postoperatively,surgical outcomes,overall survival(OS),and progression-free survival(PFS)were compared between the two groups.Results:One week postoperatively,the mean CA19-9 and neutrophil-to-lymphocyte ratio(NLR)levels in the NACT group were significantly lower than those in the No-NACT group(P<0.05).There were no statistically significant differences between the NACT and No-NACT groups in terms of complication rates(19.23%vs 24.24%)or R0 resection rates(92.31%vs 72.73%)(P>0.05).The proportion of patients with tumor size<3 cm in the NACT group was 53.85%,significantly lower than the 24.24%in the No-NACT group(P<0.05).Both OS and PFS in the NACT group were significantly longer compared to the No-NACT group(P<0.05).Conclusion:The NACT regimen of gemcitabine combined with cisplatin can reduce unfavorable tumor prognostic factors levels,prolong OS and PFS,and improve prognosis of GBC patients,with a high safety profile.

关 键 词：胆囊癌 新辅助化疗 吉西他滨 顺铂 

分 类 号：R735.8[医药卫生—肿瘤] R453[医药卫生—临床医学]