Desai Sameer, Ben-Josef Edgar, Griffith Kent A, Simeone Diane, Greenson Joel K, Francis Isaac R, Hampton Janet, Colletti Lisa, Chang Alfred E, Lawrence Theodore S, Zalupski Mark M
Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109-0934, USA.
Int J Radiat Oncol Biol Phys. 2009 Dec 1;75(5):1450-5. doi: 10.1016/j.ijrobp.2009.01.023. Epub 2009 May 4.
To report outcomes for patients with resected pancreas cancer treated with an adjuvant regimen consisting of gemcitabine-based combination chemotherapy followed by capecitabine and radiation.
We performed a retrospective review of a series of patients treated at a single institution with a common postoperative adjuvant program. Between January 2002 and August 2006, 43 resected pancreas cancer patients were offered treatment consisting of 4, 21-day cycles of gemcitabine 1 g/m(2) intravenously over 30 min on Days 1 and 8, with either cisplatin 35 mg/m(2) intravenously on Days 1 and 8 or capecitabine 1500 mg/m(2) orally in divided doses on Days 1-14. After completion of combination chemotherapy, patients received a course of radiotherapy (54 Gy) with concurrent capecitabine (1330 mg/m(2) orally in divided doses) day 1 to treatment completion.
Forty-one patients were treated. Median progression-free survival for the entire group was 21.7 months (95% confidence interval 13.9-34.5 months), and median overall survival was 45.9 months. In multivariate analysis a postoperative CA 19-9 level of >or=180 U/mL predicted relapse and death. Toxicity was mild, with only two hospitalizations during adjuvant therapy.
A postoperative adjuvant program using combination chemotherapy with gemcitabine and either cisplatin or capecitabine followed by radiotherapy with capecitabine is tolerable and efficacious and should be considered for Phase III testing in this group of patients.
报告接受以吉西他滨为基础的联合化疗，随后使用卡培他滨和放疗的辅助治疗方案的胰腺癌切除患者的治疗结果。
我们对在单一机构接受常见术后辅助治疗方案的一系列患者进行了回顾性研究。2002年1月至2006年8月期间，43例胰腺癌切除患者接受了治疗，包括4个21天周期的吉西他滨，第1天和第8天静脉滴注1 g/m²，持续30分钟，同时第1天和第8天静脉滴注顺铂35 mg/m²或第1 - 14天口服卡培他滨1500 mg/m²，分剂量服用。联合化疗完成后，患者接受一个疗程的放疗（54 Gy），同时第1天至治疗结束口服卡培他滨（1330 mg/m²，分剂量服用）。
41例患者接受了治疗。整个组的中位无进展生存期为21.7个月（95%置信区间13.9 - 34.5个月），中位总生存期为45.9个月。多因素分析显示，术后CA 19 - 9水平≥180 U/mL可预测复发和死亡。毒性较轻，辅助治疗期间仅有两次住院。
使用吉西他滨与顺铂或卡培他滨联合化疗，随后使用卡培他滨进行放疗的术后辅助治疗方案耐受性良好且有效，应考虑在这组患者中进行III期试验。
