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术后肝动脉灌注化疗改善根治性胰十二指肠切除术后胰腺癌患者的生存率:一项回顾性研究

Postoperative hepatic arterial infusion chemotherapy improved survival of pancreatic cancer after radical pancreatectomy: a retrospective study.

作者信息

Wang Yongchun, Xu Yongqiang, Zheng Yinyuan, Bao Ying, Wang Ping

机构信息

Department of General Surgery, First People's Hospital affiliated to Huzhou Normal College, Huzhou, Zhejiang Province, People's Republic of China.

Department of Radiology, First People's Hospital affiliated to Huzhou Normal College, Huzhou, Zhejiang Province, People's Republic of China.

出版信息

Onco Targets Ther. 2018 Feb 21;11:903-907. doi: 10.2147/OTT.S153886. eCollection 2018.

Abstract

OBJECTIVE

To determine the effect of postoperative hepatic arterial infusion chemotherapy (HAIC) on long-term survival of patients with pancreatic cancer (PC) after radical pancreatectomy.

METHODS

A total of 87 patients with PC underwent radical pancreatectomy in the First People's Hospital affiliated to Huzhou Normal College between June 2008 and May 2013. Among these patients, after surgery, 43 received two sessions of HAIC followed by four sessions of systemic chemotherapy (HAIC group), while 44 received six sessions of systemic chemotherapy alone (control group). Both the HAIC and systemic chemotherapy regimen included 5-fluorouracil (1,000 mg/m) as a 5-h infusion on day 1, and gemcitabine (800 mg/m) as an over 30-min infusion on days 1 and 8. The toxicity, complication, and long-term survival were retrospectively compared.

RESULTS

No significant difference in patient characteristics between the two groups was found. No chemotherapy-related deaths were recorded, and no significant difference in toxicities was observed between the two groups. The 5-year disease-free survival probability did not differ between the two groups (=0.2029, hazard ratio for recurrence=0.7561; 95% CI=0.4768-1.1989, by the log-rank test). The HAIC group had significantly higher 5-year overall survival probability (=0.0288, hazard ratio for death=0.6059; 95% CI=0.3734-0.9832, by the log-rank test) and higher 5-year hepatic metastases-free survival probability (=0.0321, hazard ratio for hepatic metastases=0.5006; 95% CI=0.2546-0.9843, by the log-rank test) than the control group.

CONCLUSIONS

Postoperative HAIC has the potential to prevent hepatic metastases and increase long-term survival probability of patients with PC after radical pancreatectomy.

摘要

目的

确定术后肝动脉灌注化疗(HAIC)对胰腺癌(PC)患者根治性胰腺切除术后长期生存的影响。

方法

2008年6月至2013年5月期间,共有87例PC患者在湖州师范学院附属第一人民医院接受了根治性胰腺切除术。在这些患者中,术后43例接受了两个疗程的HAIC,随后进行了四个疗程的全身化疗(HAIC组),而44例仅接受了六个疗程的全身化疗(对照组)。HAIC和全身化疗方案均包括5-氟尿嘧啶(1000mg/m²)在第1天进行5小时输注,吉西他滨(800mg/m²)在第1天和第8天进行超过30分钟的输注。对毒性、并发症和长期生存进行回顾性比较。

结果

两组患者特征无显著差异。未记录到化疗相关死亡,两组毒性也无显著差异。两组间5年无病生存概率无差异(=0.2029,复发风险比=0.7561;95%可信区间=0.4768-1.1989,对数秩检验)。HAIC组的5年总生存概率显著更高(=0.0288,死亡风险比=0.6059;95%可信区间=0.3734-0.9832,对数秩检验),5年无肝转移生存概率也高于对照组(=0.0321,肝转移风险比=0.5006;95%可信区间=0.2546-0.9843,对数秩检验)。

结论

术后HAIC有可能预防肝转移并提高PC患者根治性胰腺切除术后的长期生存概率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdec/5826292/8ae99805a1db/ott-11-903Fig1.jpg

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