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目的:观察生长抑素联合常规化疗对晚期胰腺癌的临床疗效并评估其安全性。方法:收集2007年3月至2009年3月不能行手术切除的晚期胰腺癌55例,随机分成两组,即常规化疗对照组与生长抑素联合常规化疗组,检测治疗前后CA19-9、CEA水平、肝肾功能及血常规;分析和比较治疗有效率:治疗对肿瘤大小(实体瘤的疗效评价,RECIST标准),无进展生存期(ProgressFree Survival,PFS)、生存期和行体力状况评分的影响以及安全性评估。结果:治疗后生长抑素联合常规化疗治疗组血清CA19-9水平明显低于常规化疗对照组(P<0.05),但CEA水平没有差异;疗程结束后联合治疗组客观有效率(OR)为60%,临床获益率(CR+PR+SD)为90%;常规组客观有效率(OR)为36%,临床获益率(CR+PR+SD)为76%;联合组客观有效率和临床获益率均明显高于常规组(P<0.05)。Karnofsky评分显示联合组提高率为36.67%(11/30);而常规组提高率为24.0%(6/25),联合组Karnofsky评分的提高率明显高于优于对照组(P<0.05);联合化疗治疗组平均生存期、中位生存期分别为372.96±34.20天、345.00±30.50天,常规化疗对照组平均生存期、中位生存期分别为307.32±29.19天、290.00±28.11天。结论:生长抑素联合化疗能明显降低CA19-9的水平;同时可提高临床疗效及患者术后生活质量及生存期,能够明显提高化疗药物的抗肿瘤活性,对于改善晚期胰腺癌的预后具有重要的临床价值。
Objective: To observe the clinical efficacy of somatostatin combined with conventional chemotherapy in patients with advanced pancreatic cancer and evaluate its safety. Methods: From March 2007 to March 2009, 55 patients with advanced pancreatic cancer who were not surgically resected were randomly divided into two groups: conventional chemotherapy control group and somatostatin combined with conventional chemotherapy group. The levels of CA19-9, CEA Level, liver and kidney function and blood routine; analysis and comparison of treatment efficiency: treatment of tumor size (solid tumor evaluation, RECIST standard), progression-free survival (ProgressFree Survival, PFS), survival and physical fitness score Impact and safety assessment. Results: The level of serum CA19-9 in the somatostatin combined with conventional chemotherapy group was significantly lower than that in the conventional chemotherapy group (P <0.05), but there was no difference in CEA level. After the treatment, the objective effective rate (OR) in the combined treatment group was 60 (CR + PR + SD) was 90%. The objective effective rate (OR) was 36% and the clinical benefit rate (CR + PR + SD) was 76% Clinical benefit rates were significantly higher than the conventional group (P <0.05). The Karnofsky score showed that the rate of improvement was 36.67% (11/30) in the combined group and 24.0% (6/25) in the conventional group. The improvement rate of Karnofsky score in the combination group was significantly higher than that in the control group (P <0.05). The mean survival and median survival of the combination chemotherapy group were 372.96 ± 34.20 days and 345.00 ± 30.50 days, respectively. The average survival time and median survival time of the conventional chemotherapy control group were 307.32 ± 29.19 days and 290.00 ± 28.11 days respectively. Conclusion: Somatostatin combined with chemotherapy can significantly reduce the level of CA19-9; at the same time can improve clinical efficacy and postoperative quality of life and survival of patients, can significantly improve the anti-tumor activity of chemotherapy drugs, for improving the prognosis of advanced pancreatic cancer is important The clinical value.