Department of Surgery, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, 573-1010, Japan.
J Hepatobiliary Pancreat Sci. 2017 May;24(5):289-296. doi: 10.1002/jhbp.447. Epub 2017 Apr 19.
We evaluated the clinical efficacy of intravenous (i.v.) and intraperitoneal (i.p.) paclitaxel (PTX) combined with S-1 in patients with chemotherapy-naïve pancreatic ductal adenocarcinoma (PDAC) with peritoneal metastasis.
Forty-nine patients were diagnosed with peritoneal metastasis during 2007-2014; 29 received gemcitabine or S-1-based chemo(radio)therapy from 2007 to 2011 (control group), and the remaining 20 received i.v. (50 mg/m ) and i.p. (20 mg/m ) PTX on days 1 and 8, and S-1 at 80 mg/m per day for 14 consecutive days, followed by 7 days of rest from 2012 to 2014 (study group).
The median survival time in the study group was significantly longer than that in the control group (20 vs. 10 months, respectively; P = 0.004). At 1 year after initial treatment, a significant difference in ascites development on CT was found between the study (5/20 patients) and the control group (18/29 patients, P = 0.009). The frequency of objective response (9/20 patients) and conversion surgery (6/20 patients) in the study group was higher than those in the control group (8/29 and 2/29, respectively). Patients who underwent conversion surgery had improved survival in both groups.
Implementation of the S-1+i.v./i.p. PTX regimen was closely associated with improved overall survival in PDAC patients with peritoneal metastasis.
我们评估了静脉（i.v.）和腹腔（i.p.）紫杉醇（PTX）联合 S-1 治疗化疗初治胰腺导管腺癌（PDAC）伴腹膜转移患者的临床疗效。
2007 年至 2014 年间，49 例患者被诊断为腹膜转移；其中 29 例患者于 2007 年至 2011 年接受吉西他滨或 S-1 为基础的化疗（放疗）（对照组），其余 20 例患者于 2012 年至 2014 年接受 i.v.（50mg/m ）和 i.p.（20mg/m ）PTX 于第 1 天和第 8 天，以及 S-1 每天 80mg/m ，连续 14 天，然后休息 7 天。
研究组的中位生存时间明显长于对照组（分别为 20 个月和 10 个月，P=0.004）。在初始治疗后 1 年，CT 上腹水发展的差异在研究组（5/20 例）和对照组（18/29 例，P=0.009）之间具有统计学意义。研究组客观缓解率（9/20 例）和转化手术率（6/20 例）高于对照组（8/29 例和 2/29 例）。进行转化手术的患者在两组中的生存均得到改善。
S-1+i.v./i.p. PTX 方案的实施与 PDAC 伴腹膜转移患者的总生存改善密切相关。
