中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2012年
9期
688-691
,共4页
王涛%刘宏%胡鹏%付卫江%梁业民%程玉峰
王濤%劉宏%鬍鵬%付衛江%樑業民%程玉峰
왕도%류굉%호붕%부위강%량업민%정옥봉
壶腹周围癌%吉西他滨%放射治疗
壺腹週圍癌%吉西他濱%放射治療
호복주위암%길서타빈%방사치료
Periampullary carcinoma%Gemcitabine%Radiotherapy
目的 探讨吉西他滨联合放射治疗或单纯化疗治疗晚期壶腹周围癌的疗效.方法 回顾性分析我院2007年1月至2010年12月收治的134例晚期壶腹周围癌患者的临床及随访资料并结合文献讨论.结果 本组134例晚期壶腹周围癌患者中男83例,女51例.年龄28～83岁不等,平均(62.49±11.41)岁.所有患者均经病理证实为壶腹周围癌.在86例接受手术的患者中,32例伴有腹腔广泛转移,27例伴有肝脏或胃等脏器转移,27例伴有腹部主要血管侵犯.86例中,有55例接受了单纯剖腹探查术,31例接受了包括剖腹探查十胆肠吻合术在内的姑息治疗.在所有患者中,有45例接受了单纯化疗治疗,其余67例接受了化疗十放疗治疗.所有患者均获随访,同时放化疗及单纯化疗均可改善患者的生活质量,临床受益率分别为73.1％和57.8％;总体生存期(14.27±1.06)个月,中位生存期11(95％ CI,8.95±13.05)个月,1年和3年生存率分别为43％和10％.对患者预后进行单因素分析显示性别、年龄、有无腹水、曾接受的手术治疗以及治疗方式与患者的生存时间无关；Karnofsky体力状态评分以及有无黄疸与生存时间相关.体力状态评分越低,患者预后越差；有黄疸的患者预后较差.进一步行多因素分析,Karnofsky体力状态评分是患者生存的独立预测因素.结论 晚期壶腹周围癌患者的预后差,单纯化疗与化疗联合放疗可以改善患者的生活质量,Karnofsky体力状态评分是患者生存的独立预测因素.
目的 探討吉西他濱聯閤放射治療或單純化療治療晚期壺腹週圍癌的療效.方法 迴顧性分析我院2007年1月至2010年12月收治的134例晚期壺腹週圍癌患者的臨床及隨訪資料併結閤文獻討論.結果 本組134例晚期壺腹週圍癌患者中男83例,女51例.年齡28～83歲不等,平均(62.49±11.41)歲.所有患者均經病理證實為壺腹週圍癌.在86例接受手術的患者中,32例伴有腹腔廣汎轉移,27例伴有肝髒或胃等髒器轉移,27例伴有腹部主要血管侵犯.86例中,有55例接受瞭單純剖腹探查術,31例接受瞭包括剖腹探查十膽腸吻閤術在內的姑息治療.在所有患者中,有45例接受瞭單純化療治療,其餘67例接受瞭化療十放療治療.所有患者均穫隨訪,同時放化療及單純化療均可改善患者的生活質量,臨床受益率分彆為73.1％和57.8％;總體生存期(14.27±1.06)箇月,中位生存期11(95％ CI,8.95±13.05)箇月,1年和3年生存率分彆為43％和10％.對患者預後進行單因素分析顯示性彆、年齡、有無腹水、曾接受的手術治療以及治療方式與患者的生存時間無關；Karnofsky體力狀態評分以及有無黃疸與生存時間相關.體力狀態評分越低,患者預後越差；有黃疸的患者預後較差.進一步行多因素分析,Karnofsky體力狀態評分是患者生存的獨立預測因素.結論 晚期壺腹週圍癌患者的預後差,單純化療與化療聯閤放療可以改善患者的生活質量,Karnofsky體力狀態評分是患者生存的獨立預測因素.
목적 탐토길서타빈연합방사치료혹단순화료치료만기호복주위암적료효.방법 회고성분석아원2007년1월지2010년12월수치적134례만기호복주위암환자적림상급수방자료병결합문헌토론.결과 본조134례만기호복주위암환자중남83례,녀51례.년령28～83세불등,평균(62.49±11.41)세.소유환자균경병리증실위호복주위암.재86례접수수술적환자중,32례반유복강엄범전이,27례반유간장혹위등장기전이,27례반유복부주요혈관침범.86례중,유55례접수료단순부복탐사술,31례접수료포괄부복탐사십담장문합술재내적고식치료.재소유환자중,유45례접수료단순화료치료,기여67례접수료화료십방료치료.소유환자균획수방,동시방화료급단순화료균가개선환자적생활질량,림상수익솔분별위73.1％화57.8％;총체생존기(14.27±1.06)개월,중위생존기11(95％ CI,8.95±13.05)개월,1년화3년생존솔분별위43％화10％.대환자예후진행단인소분석현시성별、년령、유무복수、증접수적수술치료이급치료방식여환자적생존시간무관；Karnofsky체력상태평분이급유무황달여생존시간상관.체력상태평분월저,환자예후월차；유황달적환자예후교차.진일보행다인소분석,Karnofsky체력상태평분시환자생존적독립예측인소.결론 만기호복주위암환자적예후차,단순화료여화료연합방료가이개선환자적생활질량,Karnofsky체력상태평분시환자생존적독립예측인소.
Objective To investigate the survival of advanced stage periampullary carcinoma and its prognostic factors.Methods The clinical data and follow up of 134 patients with advanced stage periampullary carcinoma admitted to our hospital between January 2007 and December 2010 were retrospectively collected and analyzed.Results Of 134 patients,there were 83 males and 51 females.The mean age±S.D.was 62.49±11.41 (28-83).For the 86 patients who underwent surgery,32 had extensive peritoneal metastases on surgical exploration,27 had metastases/involvement of the liver or stomach,and 27 had major vessel infiltration.For these 86 patients,55 received surgical exploration,whereas 31 had surgical exploration plus bypass anastomosis. 45 patients received chemotherapy,while 67 received chemotherapy plus radiotherapy.The improvements in quality of life and in clinical response rate after concurrent chemoradiotherapy or chemotherapy alone were 73.1％ and 57.8％,respectively.The overall survival was 14.27±1.06 months.The median survival time was 11 (8.95±13.05) months.The 1- and 3-year survival rates were 43％ and 10％,respectively.Karnofsky performance status,and the presence or absence of jaundice co-related with poor prognosis on single factor analysis.The Karnofsky performance status was an independent survival predictor on multifactor analysis.Conclusions The prognosis of patients with advanced stage periampullary carcinoma was poor.Chemotherapy with or without radiotherapy had similar impact on overall survival,Karnofsky performance status was an independent survival predictor.
