胰腺癌的姑息性和辅助性区域化疗

Palliative and adjuvant regional chemotherapy in pancreatic cancer.

作者信息

Link K H, Gansauge F, Görich J, Leder G H, Rilinger N, Beger H G

机构信息

Department of General Surgery, University of Ulm, Germany.

出版信息

Eur J Surg Oncol. 1997 Oct;23(5):409-14. doi: 10.1016/s0748-7983(97)93720-3.

DOI:10.1016/s0748-7983(97)93720-3

PMID:9393568

Abstract

To improve the dismal prognosis of patients (pts) with pancreatic cancer we treated 32 patients with non-resectable (UICC III, 17 pts; UICC IV, 15 pts--group 1) and 20 patients with resected (UICC I, 1 pt; UICC II, 3 pts; UICC III, 16 pts--group 2) pancreatic cancer with palliative (group I) and adjuvant post-operative (group II) coeliac axis intra-arterial cyclic infusions (CAI). CAI consisted of mitoxantrone 10 mg/m2 on day 1, folinic acid 170 mg/m2 and 5-FU 600 mg/m2 during days 2-4, and cis-platinum 60 mg/m2 on day 5 for up to 11 (group I) or six (group II) cycles. In a total of 211 cycles toxicities at the level of WHO III occurred in 0-6% and of WHO IV in 0%. The median survival times, compared with institutional historical controls (treated vs controls), were 12 vs 4.8 months in UICC III (P < 0.006) and 4 vs 2.9 months in UICC IV (P < 0.05) group I pts, and 21 vs 9.3 months in group II (P < 0.0003). Hepatic disease progression appeared to be suppressed with CAI, which also appears to be effective for palliative and adjuvant treatment in non-resectable and resected pancreatic cancer.

摘要

为改善胰腺癌患者的不良预后，我们对32例不可切除（国际抗癌联盟（UICC）III期，17例；UICC IV期，15例——第1组）和20例可切除（UICC I期，1例；UICC II期，3例；UICC III期，16例——第2组）的胰腺癌患者分别进行了姑息性（第1组）和术后辅助性（第2组）腹腔动脉内循环灌注（CAI）治疗。CAI方案为第1天米托蒽醌10 mg/m²，第2 - 4天亚叶酸170 mg/m²和5-氟尿嘧啶600 mg/m²，第5天顺铂60 mg/m²，共进行11个周期（第1组）或6个周期（第2组）。在总共211个周期中，世界卫生组织（WHO）III级毒性反应发生率为0 - 6%，WHO IV级毒性反应发生率为0%。与机构历史对照（治疗组与对照组）相比，第1组UICC III期患者的中位生存时间分别为12个月和4.8个月（P < 0.006），UICC IV期患者为4个月和2.9个月（P < 0.05）；第2组患者为21个月和9.3个月（P < 0.0003）。CAI似乎能抑制肝脏疾病进展，对不可切除和可切除胰腺癌的姑息性及辅助性治疗均有效。