吉西他滨治疗局部晚期胰腺癌的疗效：与基于5-氟尿嘧啶的放化疗对比

Efficacy of gemcitabine for locally advanced pancreatic cancer: comparison with 5-fluorouracil-based chemoradiotherapy.

作者信息

Tada Minoru, Arizumi Toshihiko, Nakai Yousuke, Sasaki Takashi, Kogure Hirofumi, Togawa Osamu, Matsubara Saburo, Tsujino Takeshi, Hirano Kenji, Sasahira Naoki, Isayama Hiroyuki, Kawabe Takao, Omata Masao

机构信息

Department of Gastroenterology, University of Tokyo, Tokyo, Japan.

出版信息

Chemotherapy. 2008;54(4):302-8. doi: 10.1159/000151226. Epub 2008 Aug 8.

DOI:10.1159/000151226

PMID:18689983

Abstract

BACKGROUND

The efficacy of gemcitabine alone has not been established in comparison with conventional chemoradiotherapy for locally advanced pancreatic cancer.

METHODS

Of 180 consecutive patients with unresectable advanced pancreatic cancer, 93 were locally advanced. Among these 93 patients, 45 were treated with gemcitabine, 18 with concurrent radiotherapy and 5-fluorouracil-based chemotherapy, and 30 received best supportive care (BSC). In cases of metastatic disease, 42 were treated with gemcitabine and 32 received BSC. Overall survival and adverse events were analyzed retrospectively.

RESULTS

Median survival time and 1-year survival rate were 11.6, 9.3, 6.7, 7.8 and 2.4 months and 47, 39, 27, 21 and 7% in the groups of gemcitabine, chemoradiotherapy, BSC of locally advanced cancer, and in those of gemcitabine, BSC of metastatic disease, respectively. Gemcitabine and chemoradiotherapy prolonged overall survival time compared with BSC (p = 0.0071). No significant difference in survival was observed between gemcitabine and chemoradiotherapy for locally advanced cases. Adverse events >grade 3 were observed in 25 of 87 (29%) of gemcitabine-treated and in 3 of 18 (17%) of chemoradiotherapy-treated patients.

CONCLUSION

Gemcitabine monotherapy for locally advanced pancreatic cancer could be as effective as previous chemoradiotherapy.

摘要

背景

与传统放化疗相比，吉西他滨单药治疗局部晚期胰腺癌的疗效尚未确立。

方法

在180例连续的不可切除的晚期胰腺癌患者中，93例为局部晚期。在这93例患者中，45例接受吉西他滨治疗，18例接受同步放疗及基于5-氟尿嘧啶的化疗，30例接受最佳支持治疗（BSC）。对于转移性疾病患者，42例接受吉西他滨治疗，32例接受BSC。对总生存期和不良事件进行回顾性分析。

结果

吉西他滨组、放化疗组、局部晚期癌症的最佳支持治疗组以及转移性疾病的吉西他滨组、最佳支持治疗组的中位生存期分别为11.6、9.3、6.7、7.8和2.4个月，1年生存率分别为47%、39%、27%、21%和7%。与最佳支持治疗相比，吉西他滨和放化疗延长了总生存期（p = 0.0071）。对于局部晚期病例，吉西他滨和放化疗之间未观察到生存方面的显著差异。在接受吉西他滨治疗的87例患者中有25例（29%）发生3级以上不良事件，在接受放化疗的18例患者中有3例（17%）发生。