经皮胆道引流术联合化疗治疗伴胆道梗阻的胰腺或胆道恶性肿瘤患者可改善生存。

Chemotherapy Improves Survival After Percutaneous Biliary Drainage in Patients With Pancreatic or Biliary Tract Cancer With Biliary Obstruction.

机构信息

Department of Surgery, Oulu University Hospital and Medical Research Center, Oulu, Finland;

Department of Infection Control, Oulu University Hospital, Oulu, Finland.

出版信息

Anticancer Res. 2021 Jun;41(6):2979-2984. doi: 10.21873/anticanres.15079.

DOI:10.21873/anticanres.15079

PMID:34083288

Abstract

BACKGROUND

The survival benefit of chemotherapy compared to best supportive care (BSC) after percutaneous transhepatic biliary drainage (PTBD) was evaluated in patients with pancreatic or biliary tract cancer.

PATIENTS AND METHODS

A retrospective registry study was conducted at a tertiary-level university hospital. The endpoint was survival measured from the PTBD and the initiation of chemotherapy.

RESULTS

Among 158 patients (mean age=74 years, range=43-93 years; 51.9% women), 82 (51.9%) had pancreatic cancer and 76 (48.1%) had biliary tract cancer. After PTBD, 32 (20.3%) patients received chemotherapy and had a median survival of 11.7 months; 126 (79.7%) patients received only BSC resulting in a median survival of 1.7 months. The hazard ratio for survival at 1 year for patients who received chemotherapy compared to BSC was 0.22 (95% confidence interval=0.12-0.41, p<0.001).

CONCLUSION

After PTBD, patients with pancreatic or biliary tract cancer should be critically evaluated by an oncologist to determine whether chemotherapy is possible, as it seems to significantly improve survival compared to BSC.

摘要

背景

经皮经肝胆道引流术（PTBD）后，与最佳支持治疗（BSC）相比，化疗对胰腺癌或胆道癌患者的生存获益进行了评估。

患者和方法

在一所三级大学医院进行了回顾性登记研究。终点是从 PTBD 到开始化疗的生存时间。

结果

在 158 名患者中（平均年龄 74 岁，范围 43-93 岁；51.9%为女性），82 名（51.9%）患有胰腺癌，76 名（48.1%）患有胆道癌。在 PTBD 后，32 名（20.3%）患者接受了化疗，中位生存时间为 11.7 个月；126 名（79.7%）患者仅接受 BSC，中位生存时间为 1.7 个月。与 BSC 相比，接受化疗的患者 1 年生存率的风险比为 0.22（95%置信区间=0.12-0.41，p<0.001）。