CAJ | 학술논문

目的：观察替吉奥（S -1）联合吉西他滨诱导化疗后，行 S -1同步放化疗并用 S -1维持治疗中晚期胰腺癌的安全性和近期疗效。方法：选择无法手术及无远处转移的局部晚期胰腺癌患者32例，ECOG 评分0～1分，无抗肿瘤治疗史。患者先接受2周期 S -1加吉西他滨诱导化疗，吉西他滨1000mg/ m2，第1天，第8天；S -140mg/ m2，每日2次，第1～14天，21天为1个周期；2周后行 S -1同步放化疗，80mg/ m2，每日1次，第1～14天及第22～35天，放疗为调强放射治疗，总剂量为50.4Gy（1.8Gy/天，5次/周，28次）。放化疗结束后1个月，口服替吉奥维持治疗，S -1为80mg/ m2，每日1次，口服14天，休息14天，直至病情进展，或出现无法耐受的毒副反应即停止治疗。中位随访时间为15.6个月（8.6～32.3个月）。结果：32例患者完成诱导化疗。30例患者（93.8％）完成同步放化疗，没有发生与治疗相关的死亡和 IV 级毒副反应。主要毒副反应包括白细胞减少和恶心。有17例患者达 PR（53.1％），9例患者达 SD（28.1％），4例患者出现病情进展（12.5％）。中位无进展生存期9.3个月，中位总生存期15.2个月。1年和2年生存率分别为75％和34.4％。结论：S -1联合吉西他滨诱导化疗后，行 S -1同步放化疗并用 S -1维持治疗中晚期胰腺癌耐受性好，疗效肯定。
목적：관찰체길오（S -1）연합길서타빈유도화료후，행 S -1동보방화료병용 S -1유지치료중만기이선암적안전성화근기료효。방법：선택무법수술급무원처전이적국부만기이선암환자32례，ECOG 평분0～1분，무항종류치료사。환자선접수2주기 S -1가길서타빈유도화료，길서타빈1000mg/ m2，제1천，제8천；S -140mg/ m2，매일2차，제1～14천，21천위1개주기；2주후행 S -1동보방화료，80mg/ m2，매일1차，제1～14천급제22～35천，방료위조강방사치료，총제량위50.4Gy（1.8Gy/천，5차/주，28차）。방화료결속후1개월，구복체길오유지치료，S -1위80mg/ m2，매일1차，구복14천，휴식14천，직지병정진전，혹출현무법내수적독부반응즉정지치료。중위수방시간위15.6개월（8.6～32.3개월）。결과：32례환자완성유도화료。30례환자（93.8％）완성동보방화료，몰유발생여치료상관적사망화 IV 급독부반응。주요독부반응포괄백세포감소화악심。유17례환자체 PR（53.1％），9례환자체 SD（28.1％），4례환자출현병정진전（12.5％）。중위무진전생존기9.3개월，중위총생존기15.2개월。1년화2년생존솔분별위75％화34.4％。결론：S -1연합길서타빈유도화료후，행 S -1동보방화료병용 S -1유지치료중만기이선암내수성호，료효긍정。
Objective:To investigate the feasibility and efficacy of the combination of S - 1 with gemcitabine fol-lowed by oral S - 1 with concurrent radiotherapy(intensity modulated radiotherapy,IMRT)and maintenance therapy with S - 1 for locally advanced pancreatic cancer. Methods:Subjects selected in the study were patients who had unr-esectable and locally advanced pancreatic cancer without distant metastases,adequate organ and marrow functions,an Eastern Cooperative Oncology Group performance status of 0 ~ 1 and no prior anticancer therapy. Initially the subjects received two cycles of chemotherapy,oral administration of S - 1 40mg/ m2 twice daily from day 1 to day 14 of a 21d cycle,with 30min intravenous infusions of gemcitabine 1 000mg/ m2 on day 1 and day 8. Two weeks after the comple-tion of chemotherapy,S - 1 was administered orally with concurrent IMRT. Oral S - 1 was administered at a dose of 80mg/ m2 per day twice daily from day 1 to day 14 and from day 22 to day 35. Radiation was concurrently delivered at a dose of 50. 4Gy(1. 8Gy/ d,5 times per week,28 fractions). One month after the completion of chemotherapy and radiotherapy,S - 1 was administered orally at a dose of 80mg/ m2 per day twice daily for 14d,followed by a 14d rest period. This cycle was repeated as maintenance therapy,until unacceptable toxicity occurred or the disease worsened. Thirty - two patients were involved in this study. The median follow - up was 15. 6 months( range:8. 6 ~ 32. 3 months). Results:Thirty - two patients completed the scheduled course of chemotherapy,while 30 patients (93. 8% )received chemoradiotherapy with two patients ceasing to continue with radiotherapy. The major toxic effects were nausea and leukopenia. There was no grade IV toxicity or treatment - related death. According to the Response Evaluation Criteria in Solid Tumors criteria,the objective tumor response was partial response in 17(53. 1% )pa-tients,stable disease in 9(28. 1% ),and progressive disease in 4(12. 5% ). The median overall survival and median progression - free survival were 15. 2 months and 9. 3 months,respectively. The survival rates at 1 year and 2 years were 75% and 34. 4% ,respectively. Conclusion:The combination of S - 1 with gemcitabine followed by oral S - 1 with IMRT and maintenance therapy with S - 1 alone in patients with locally advanced pancreatic cancer may be con-sidered a well - tolerated,promising treatment regimen.