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目的探讨吉西他滨联合替吉奥治疗局部晚期和转移性胰腺导管腺癌的疗效和不良反应,以及可能影响患者生存的因素。方法回顾性分析北京协和医院肿瘤内科2014年1月至2017年1月病理确诊并接受吉西他滨联合替吉奥方案(第1、8天吉西他滨1000 mg/m~2静脉滴注30 min;第1~14天口服替吉奥40~60 mg/次,每日2次,每21天为1个周期)一线治疗的胰腺导管腺癌患者的临床资料,所有患者至少接受2周期化疗、有疗效评估和随访资料。结果 60例晚期胰腺癌患者纳入分析,疾病部分缓解13例(22%),稳定37例(61%),进展10例(17%),总体中位无进展生存期7个月(95%CI=6-10),中位总生存期12个月(95%CI=9-20)。单因素分析和多因素分析均显示原发灶切除对无进展生存期、肺转移对总生存期有显著影响。最常见3~4度不良反应为中性粒细胞减少(27%)、白细胞减少(18%)。结论吉西他滨联合替吉奥方案一线治疗晚期胰腺癌有效率较高,不良反应易于管理。
Objective To investigate the curative effect and side effects of gemcitabine combined with tiagre for the treatment of locally advanced and metastatic pancreatic ductal adenocarcinoma and the factors that may affect the survival of patients. Methods A retrospective analysis was performed on the department of Oncology of Peking Union Medical College Hospital from January 2014 to January 2017. The patients were diagnosed with gemcitabine plus tegaserod (gemcitabine 1000 mg / m ~ 2 on day 1 and day 18 for 30 min; 14 days oral tiaggiao 40 ~ 60 mg / time, 2 times a day, every 21 days for a cycle) of first-line treatment of pancreatic ductal adenocarcinoma patients with clinical data, all patients received at least 2 cycles of chemotherapy, efficacy evaluation and Follow-up information. Results Sixty patients with advanced pancreatic cancer were included in the analysis. Thirteen patients (22%) were partially relieved, 37 (61%) were stable, 10 (17%) were advanced, and the overall median progression-free survival was 7 months (95% CI = 6-10) with a median overall survival of 12 months (95% CI = 9-20). Univariate analysis and multivariate analysis showed that primary resection had no significant effect on progression-free survival and lung metastasis on overall survival. The most common 3 to 4 degrees of adverse reactions were neutropenia (27%), leukopenia (18%). Conclusion The combination of gemcitabine and tegaserod for first-line treatment of advanced pancreatic cancer is more effective and the adverse reactions are easy to manage.