吉西他滨联合替吉奥与联合顺铂治疗晚期胰腺癌的疗效比较

Comparison of clinical efficacy of Gemcitabine plus S-1 with Gemcitabine plus Cisplatin in treatment of advanced pancreatic cancer

摘要:

对比吉西他滨联合替吉奥与吉西他滨联合顺铂治疗晚期胰腺癌的临床疗效与安全性。方法45 例晚期胰腺癌患者，随机分为吉西他滨联合替吉奥组（GS 组，23 例）与吉西他滨联合顺铂组（GP 组，22 例）。GS 组：吉西他滨1 000 mg/m2，第1 和8天静脉滴注，替吉奥胶囊75 mg/（m2·d），第1～14 天餐后30 min 口服，2 次/d，21 d 为一周期；GP组：吉西他滨1 000 mg/m2，第1 和8 天静脉滴注，顺铂25 mg/（m2·d），第2～4 天静脉滴注，21 d为一周期。结果GS 组与GP 组疾病控制率（CR+PR+SD）分别为78.3%和72.7%，差异无统计学意义（p >0.05）。GS 组与GP 组中位无疾病进展时间分别为5.75 个月和4.50 个月（p <0.05），中位总生存时间分别为9 个月和8 个月（ p>0.05）。两组主要毒副反应为血液学毒性及消化道反应，CP组恶心、呕吐发生率高于GS 组，差异有统计学意义（ p<0.05）。结论吉西他滨联合替吉奥与联合顺铂治疗晚期胰腺癌安全有效，前者较后者毒副发生率低且可耐受,延长生存期方面有一定优势，但差异无统计学意义。

Abstract:

To compare the clinical efficacy and safety of Gemcitabine plus S-1 with Gemcitabine plus Cisplatin in the treatment of advanced pancreatic cancer. Methods Forty-five patients with advanced pancreatic cancer were randomly divided into Gemcitabine plus S-1 (GS) group (23 cases) and Gemcitabine plus Cisplatin (GP)group (22 cases). The patients in the GS group were treated with Gemcitabine 1000 mg/m2 intravenous drip on days 1 and 8, and S-1 capsules 75 mg/(m2·d), twice a day on days 1-14, repeated every 21 days. The patients in the GP group received Gemcitabine 1000 mg/m2 intravenous drip on days 1 and 8, and Cisplatin 25 mg/(m2·d) intravenous drip on days 2-4, repeated every 21 days. Results The disease control rate was 78.3% in the GS group and 72.7% in the GP group, there was no significant difference ( p> 0.05). In the GS group and the GP group, the median progression-free survival (PFS) was 5.75 months and 4.5 months respectively ( p< 0.05), and the median overall survival was 9 months and 8 months respectively (p > 0.05). The main adverse reactions were hematology toxicity and gastrointestinal reactions in both groups. The incidences of nausea and vomiting in the GP group were significantly higher than those in the GS group (p < 0.05). Conclusions Both regimens are effective and safe for the treatment of advanced pancreatic cancer. Compared to the GP regimen, GS regimen has lower incidences of adverse reactions and excellent tolerance, it also shows superiority in prolonging survival time though without statistical difference.