低分子量肝素（LMWH）可提高顺铂加吉西他滨联合用药治疗晚期胰腺癌的疗效。

Low molecular weight heparin (LMWH) increases the efficacy of cisplatinum plus gemcitabine combination in advanced pancreatic cancer.

作者信息

Icli Fikri, Akbulut Hakan, Utkan Gungor, Yalcin Bülent, Dincol Dilek, Isikdogan Abdurrahman, Demirkazik Ahmet, Onur Handan, Cay Filiz, Büyükcelik Abdullah

机构信息

Department of Medical Oncology, Ankara University School of Medicine, Ankara, Turkey.

出版信息

J Surg Oncol. 2007 May 1;95(6):507-12. doi: 10.1002/jso.20728.

DOI:10.1002/jso.20728

PMID:17192920

Abstract

BACKGROUND

In this non-randomized study we aimed to assess the efficacy of the addition of low molecular weight heparin (LMWH) to gemcitabine (GEM) plus cisplatinum (CDDP) combination chemotherapy on survival by prevention of thromboembolic complications in patients with advanced pancreatic cancer (APC).

PATIENTS AND METHODS

Between November 1999 and February 2004, 69 consecutive patients with APC were treated with GEM (800 mg/m2, day 1, day 8) plus CDDP (35 mg/m2, day 1, day 8) every 21 days +/-LMWH (nadroparine calcium, 2,850 IU/day until disease progression). Ten out of 35 patients in LMWH group and 10 out of 34 patients in chemotherapy alone group had primary inoperable locally advanced disease and the rest of the patients had metastatic disease.

RESULTS

Total response rate was 58.8% (11.7% CR) for the patients treated with LMWH and 12.1% for those treated without LMWH (P = 0.0001). LMWH group had a better median time to progression (TTP) and survival when compared to control group (7.3 vs. 4.0 months, P = 0.0001; 13.0 vs. 5.5 months, P = 0.0001). The toxicity was similar and acceptable in both groups.

CONCLUSION

Addition of LMWH to GEM plus CDDP combination significantly improved the response and survival in patients with APC and the current schedule deserves to be tested in phase III trials.

摘要

背景

在这项非随机研究中，我们旨在评估在吉西他滨（GEM）加顺铂（CDDP）联合化疗基础上加用低分子量肝素（LMWH）对晚期胰腺癌（APC）患者预防血栓栓塞并发症及生存的疗效。

患者与方法

1999年11月至2004年2月期间，69例连续的APC患者接受每21天一次的GEM（800mg/m²，第1天、第8天）加CDDP（35mg/m²，第1天、第8天）治疗，±LMWH（那屈肝素钙，2850IU/天，直至疾病进展）。LMWH组35例患者中有10例以及单纯化疗组34例患者中有10例为原发性不可切除的局部晚期疾病，其余患者为转移性疾病。

结果

接受LMWH治疗的患者总缓解率为58.8%（完全缓解率为11.7%），未接受LMWH治疗的患者为12.1%（P = 0.0001）。与对照组相比，LMWH组的中位疾病进展时间（TTP）和生存期更好（7.3个月对4.0个月，P = 0.0001；13.0个月对5.5个月，P = 0.0001）。两组的毒性相似且可接受。