吉西他滨联合替吉奥新辅助化疗治疗可切除胰腺导管腺癌的临床意义。
Clinical Significance of Neoadjuvant Chemotherapy With Gemcitabine Plus S-1 for Resectable Pancreatic Ductal Adenocarcinoma.
机构信息
Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan.
Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
出版信息
In Vivo. 2019 Nov-Dec;33(6):2027-2035. doi: 10.21873/invivo.11700.
BACKGROUND/AIM: Little is known about the efficacy of neoadjuvant chemotherapy (NAC) with gemcitabine plus S-1 (GS) for patients with resectable pancreatic ductal adenocarcinoma (R-PDAC). The aim of this study was to investigate differences in the long-term outcome of patients with R-PDAC undergoing pancreatectomy with and without NAC-GS to clarify the clinical significance of NAC-GS.
PATIENTS AND METHODS
A total of 77 patients with R-PDAC who were scheduled for pancreatectomy between January 2012 and December 2017 were enrolled. Of these patients, 39 received NAC-GS (GS group) and 38 had upfront surgery (UFS group).
RESULTS
Among the 77 patients, one patient in each group did not undergo pancreatectomy due to intraoperative non-curative factors. Median tumor size and the number of lymph nodes with metastasis were significantly lower in the GS group than in the UFS group (p=0.002 and p=0.017). However, the 5-year overall survival rate was similar in the two groups (26.1% versus 21.5%, p=0.930).
CONCLUSION
NAC-GS may not be recommended for patients with R-PDAC since it does not seem to offer any survival benefits.
背景/目的：对于可切除胰腺导管腺癌（R-PDAC）患者，吉西他滨加 S-1（GS）新辅助化疗（NAC）的疗效知之甚少。本研究旨在探讨接受 NAC-GS 与未接受 NAC-GS 的 R-PDAC 患者行胰切除术的长期预后差异，以阐明 NAC-GS 的临床意义。
患者和方法
共纳入 2012 年 1 月至 2017 年 12 月期间计划接受胰切除术的 77 例 R-PDAC 患者。其中 39 例接受 NAC-GS（GS 组），38 例直接手术（UFS 组）。
结果
在 77 例患者中，每组各有 1 例患者因术中非治愈因素未行胰切除术。GS 组的中位肿瘤大小和转移淋巴结数量明显低于 UFS 组（p=0.002 和 p=0.017）。然而，两组的 5 年总生存率相似（26.1%比 21.5%，p=0.930）。
结论
由于 NAC-GS 似乎并未带来生存获益，因此不建议将其用于 R-PDAC 患者。
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