CAJ | 학술논문

目的：在真实临床背景下，比较吉西他滨联合奥沙利铂或替吉奥对比吉西他滨单药治疗晚期胰腺癌的疗效和不良反应。方法87例晚期胰腺癌患者分为三组：吉西他滨单药组（ G组）23例，吉西他滨1000 mg · m－2，静滴30 min，第1、8天。吉西他滨联合奥沙利铂组（GM组）33例，在G组基础上联合奥沙利铂130 mg· m－2，第1天。吉西他滨联合替吉奥胶囊组（ GS组）31例，在G组基础上联合口服替吉奥胶囊80／100／120 mg· d－1，每天2次，第1～14天；三组均每21 d为一周期。每2～3个周期进行评价。结果三组比较，其有效率（RR）、疾病控制率（DCR）和临床受益率（CBR）均未取得统计学意义（P＞0．0167）；GM组和GS组的中位无进展生存（PFS）和中位总生存时间（OS）均明显高于G组，差异有统计学意义（P＜0．0167）；而GM组和GS组比较，虽后者略显优势，但差异无统计学意义（P＞0．0167）。三组患者的主要不良反应为血液学毒性和消化道反应，联合化疗组的末梢神经损害和皮疹发生率略高于单药组，但差异不显著（ P＞0．05）。结论在真实临床背景下，GM方案和GS方案较吉西他滨单药治疗晚期胰腺癌可获得更好的生存期，且不良反应可以耐受，二者均可作为首选治疗方案。
목적：재진실림상배경하，비교길서타빈연합오사리박혹체길오대비길서타빈단약치료만기이선암적료효화불량반응。방법87례만기이선암환자분위삼조：길서타빈단약조（ G조）23례，길서타빈1000 mg · m－2，정적30 min，제1、8천。길서타빈연합오사리박조（GM조）33례，재G조기출상연합오사리박130 mg· m－2，제1천。길서타빈연합체길오효낭조（ GS조）31례，재G조기출상연합구복체길오효낭80／100／120 mg· d－1，매천2차，제1～14천；삼조균매21 d위일주기。매2～3개주기진행평개。결과삼조비교，기유효솔（RR）、질병공제솔（DCR）화림상수익솔（CBR）균미취득통계학의의（P＞0．0167）；GM조화GS조적중위무진전생존（PFS）화중위총생존시간（OS）균명현고우G조，차이유통계학의의（P＜0．0167）；이GM조화GS조비교，수후자략현우세，단차이무통계학의의（P＞0．0167）。삼조환자적주요불량반응위혈액학독성화소화도반응，연합화료조적말소신경손해화피진발생솔략고우단약조，단차이불현저（ P＞0．05）。결론재진실림상배경하，GM방안화GS방안교길서타빈단약치료만기이선암가획득경호적생존기，차불량반응가이내수，이자균가작위수선치료방안。
Objective To compare the efficacy and adverse reactions of gemcitabine plus oxaliplatin or S-1 with single-agent gemcit-abine in the treatment of advanced pancreatic cancer in a real clinical setting.Methods 87 patients were divided into three groups. Twenty-three cases were included in single-agent gemcitabine group ( G group) , and they were treated with gemcitabine 1 000 mg· m-2 for a 30-minute infusion on days 1 and 8.Thirty-three cases were included in gemcitabine plus oxaliplatin group (GM group), which were given oxaliplatin 130mg· m-2 in the first day on the basis of the G Group.The rest 31 cases were included in gemcitabine plus S-1 capsules group ( GS group) , which were given S-1 capsules 80/100/120 mg· d-1 , twice a day on days 1~14 on the basis of the G Group.Three groups were repeated every 21 days.Assessment was done after every 2~3 cycles.Results Among the three groups, the total effective rates (RR), disease control rates (DCR) and clinical benefit response rates (CBR) were not statistically significant (P >0.0167).The median PFS and median OS in GM group and GS group were significantly higher than the G group (P<0.0167) .Between GM group and GS group, although the latter was slightly better, but the difference had no statistical significance (P>0.0167).The main adverse reactions of the three groups were hematologic and gastrointestinal toxicities.The incidences of pe-ripheral nerve damage and skin rashes in the combined chemotherapy group were slightly higher than those in the single-agent chemo-therapy group, but the differences were not significant (P>0.05).Conclusions In a real clinical setting, compared with the single-agent gemcitabine, GM and GS regimens can achieve better survival time in the treatment of advanced pancreatic cancer, and adverse reactions can be tolerated.Both GM and GS regimens can be used as the first-line regimen.