摘要
目的探讨胆管下段癌行根治性胰十二指肠切除术后辅助化疗效果。方法回顾性分析自2016年1月至2019年1月宁波市医疗中心李惠利东部院区收治的23例胆管下段癌行根治性胰十二指肠切除术患者的临床资料,根据术后是否接受化疗分为2组,其中化疗组[GEMOX方案(吉西他滨1000 mg/m2,d1,d8;奥沙利铂130 mg/m2,d1;3周1疗程)]10例和未化疗组13例,比较分析两组术后生存状况(中位生存时间、12个月生存率、累积生存率及无复发生存率)。结果化疗组随访1~30个月,5例死亡,5例存活;未化疗组随访6~28个月,5例死亡,8例存活。化疗组中位生存时间为21个月,未化疗组中位生存时间为22个月(P>0.05)。化疗组和未化疗组12个月生存率分别为80%(8/10)和77%(10/13)。两组累积生存率比较,差异无统计学意义(χ~2=0.277,P>0.05)。化疗组中位无复发生存时间为15个月,未化疗组为13个月,两组无复发生存率比较,差异无统计学意义(χ~2=0.002,P>0.05)。结论以吉西他滨+奥沙利铂为主要方案的术后辅助化疗不能使胆管下段癌R0切除患者明显获益。
Objective To investigate the efficacy of adjuvant chemotherapy after radical pancreaticoduodenectomy for lower bile duct cancer.Methods Clinical data of 23 patients with lower bile duct cancer that underwent radical pancreaticoduodenectomy in Eastern Branch of Ningbo Medical Center Li Huili Hospital from Jan.2016 to Jan.2019 were analyzed retrospectively.Patients were divided into chemotherapy group(n=10,Gemcitabine 1000 mg/m2,d1,d8;Oxaliplatin 130 mg/m2,d1;3 week treatment)and non-chemotherapy group(n=13).The postoperative status(median survival,12-month survival rate,cumulative survival rate and recurrence-free survival rate)was compared between the two groups.Results The 10 patients in chemotherapy group were followed-up for 1~30 months,among which,5 cases died and 5 survived.The 13 patients in nonchemotherapy group were followed-up for 6~28 months,among which,5 cases died and 8 survived.The median survival in chemotherapy group was 21 months and that in non-chemotherapy group was 22 months(P>0.05).The 12-month survival rate of chemotherapy group and non-chemotherapy group were 80%(8/10)and 77%(10/13),respectively.The difference in the cumulative survival rate between the two groups was not statistically significant(χ2=0.277,P>0.05).The median recurrence-free survival in chemotherapy group was 15 months and that in non-chemotherapy group was 13 months.The difference in the recurrence-free survival rate between the two groups was not statistically significant(χ2=0.002,P>0.05).Conclusion Postoperative adjuvant chemotherapy with Gemcitabine plus Oxaliplatin as the primary scheme cannot significantly benefit patients with lower bile duct cancer after R0 resection.
作者
周叶明
张孔亮
朱宏达
陆才德
华永飞
ZHOU Ye-ming;ZHANG Kong-liang;ZHU Hong-da;LU Cai-de;HUA Yong-fei(Department of Hepatobiliary and Pancreatic Surgery,Eastern Branch,Ningbo Medical Center Li Huili Hospital,Ningbo,Zhejiang 315000,China;Department of Surgery,Health Corps of 91715 PLA Troops,Guangzhou 510000,China)
出处
《肝胆胰外科杂志》
CAS
2019年第11期656-658,666,共4页
Journal of Hepatopancreatobiliary Surgery
基金
宁波市科技创新团队（2013B82010）
宁波市医疗卫生品牌学科建设项目（PPXK2018-03）
关键词
胆管下段癌
胰十二指肠切除术
辅助化疗
lower bile duct cancer
pancreaticoduodenectomy
adjuvant chemotherapy
