摘要
目的分析进展期胆囊癌根治术后应用替吉奥胶囊联合吉西他滨化疗的临床疗效及毒副反应。方法回顾性分析郑州大学第一附属医院肝胆胰外科2007年6月-2012年6月收治的术后病理证实为进展期胆囊癌的135例患者资料。其中单纯手术组（胆囊癌根治术或胆囊癌扩大根治术）47例，术后化疗A组（胆囊癌根治术后或胆囊癌扩大根治术后应用替吉奥胶囊联合吉西他滨化疗）52例，术后化疗B组（胆囊癌根治术后或胆囊癌扩大根治术后应用5-氟尿嘧啶联合奥沙利铂化疗）36例。统计患者术后中位生存时间、1、3、5年生存率及化疗毒副反应发生率。结果三组患者性别、年龄、肿瘤大小、CA19-9、CA125、TNM分期、是否合并胆囊结石、手术方式及术后并发症发生率差异无统计学意义。单纯手术组与术后化疗A组或化疗B组的中位生存时间（分别为19、27和25个月）差异有统计学意义（P〈0．05）。术后1年三组生存率（分别为87．2％、90．0％、81．3％）差异无统计学意义，单纯手术组和术后化疗A组或术后化疗B组的术后3、5年生存率（分别为19．1％、4．3％；40．O％、18．O％；40．6％、21．9％）差异均有统计学意义（均P〈0．05），术后化疗组患者生存率明显提高。术后化疗A组与化疗B组中位生存时间以及1、3、5年生存率差异无统计学意义。术后化疗A组与化疗B组主要毒副反应总发生率差异有统计学意义（55．8％比88．9％；P〈0．05），化疗B组Ⅲ度以上毒副反应发生率（27．8％，10／36）较化疗A组高（5．8％，3／52），差异有统计学意义（P〈0．05）。结论进展期胆囊癌根治术后应用替吉奥胶囊联合吉西他滨化疗与5一氟尿嘧啶联合奥沙利铂化疗比较，前者的毒副反应发生率低且毒副反应多为轻度，Ⅲ度以上的毒性反应发生率明显少于后者。两种化疗方案在患者术后预后方面无明显差异。对于进展期胆囊癌患者，术后辅助应用替吉奥胶囊联合吉西他滨化疗可明显延长患者术后中位生存时间，有效提高术后3、5年生存率。
Objective To analyze the clinical efficacy and toxic reaction of Tegafur, Gimeraciland Oteracil Potassium Capsule combined with Gemcitabine chemotherapy for patients with radical resection for advanced gallbladder carcinoma. Methods The clinical dataof 135 patients with advanced gallbladder cancer who were admitted to the 1 st Affiliated Hospital of Zhengzhou University and supported after the gastrectomy by the pathology from June 2007 to June 2012 were retrospectively analyzed. All patients were divided into three groups by different therapeutic regimens, operation groups （Radical resection or Extended radical resection of gallbladder carcinoma） with 47 cases, chemotherapy A group （ Tegafur, Gimeracil and Oteracil Potassium Capsule combined with Gemcitabine chemotherapy after Radical resection or Extended radical resection of gallbladder carcinoma） with 52 cases, and chemotherapy B group （5-Fluorouracil combined with Oxaliplatin chemotherapy after Radical resection or Extended radical resection of gallbladder car- cinoma） with 36 cases. We collected the dates of all patients with the median survival time and the 1,3 and 5-year survival rate after operation, and counted the rate of major toxic reaction after chemotherapy. Results There were no significant differences in the general date of three groups （sex, age, tumor size, CA199,CA125, TNM stages, with or without cholecystolithiasis, operation methods, operation complication）, The chemotherapy A group and chemotherapy B group had no differenceswiththe median survival time and 1, 3 and 5-year survival rate after operation. There were significant differences in the median survival time and 3, 5-year survival rate after operation between the operation group and chemotherapy A group （or between the operation group and chemotherapy B group ）. There were significant differences in the rate of whole toxic reaction and the rate of toxic reaction beyond Ⅲ degree between chemotherapy A group and chemotherapy B group. Conclusions The treatment of Tegafur, Gimeracil and Oteracil Potassium Capsule combined with Gemcitabine chemotherapy for patients with radical resection of advanced gallbladder carcinoma has a lower rate of whole toxic reaction and rate of toxic reaction beyond Ⅲ degree than 5-Fluorouracil combined with Oxaliplatin chemotherapy, and for patients with advanced gallbladder carcinoma, the frontal treatment can obviously prolong the median survival time and effectively improve the 3 and 5-year survival rate after operation.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2018年第1期29-33,共5页
Chinese Journal of Hepatobiliary Surgery
关键词
进展期胆囊癌
胆囊癌根治术
替吉奥胶囊
吉西他滨
5-氟尿嘧啶
奥沙利铂
Advanced galtbladder carcinoma
Radical resection of gallbladder carcinoma
Tegafur, Gimeracil and Oteracil Potassium Capsule
Gemcitabine
5-Fluorouracil
Oxaliplatin
