摘要
背景与目的:胰腺癌是预后较差的恶性肿瘤之一,动脉灌注化疗/栓塞(hepatic arteryinfusion chemotherapy/transcatheter arterial chemoembolization,HAI/TACE)治疗胰腺癌取得了一定临床疗效。本研究通过中药清热化积法联合HAI/TACE治疗Ⅲ～Ⅳ期胰腺癌患者的随机对照Ⅱ期临床研究,探讨清热化积法的临床疗效以及血清CA199水平在胰腺癌预后中的价值。方法:选择2006年5月—2009年6月,在复旦大学附属肿瘤医院中西医结合科住院的Ⅲ～Ⅳ期胰腺癌患者70例,均接受HAI/TACE治疗。根据数字表法随机分为两组:清热化积中药治疗组(35例)和对照组(35例),比较清热化积中药与对照中药分别联合HAI/TACE治疗3、6、9和12个月生存情况,治疗前后的患者主要症状变化,采用RECIST标准评价治疗前后B超、CT或MRI等影像学中胰腺肿瘤大小的变化。结果:清热化积组中位生存期为6.94个月优于对照组的4.24个月(P<0.05)。清热化积中药治疗前后肝肾功能的变化、骨髓抑制情况与对照组比较差异无统计学意义(P>0.05)。清热化积组的患者中血清CA199<500 U/mL和CA199>500 U/mL的中位生存期分别为(9.40±2.28)个月和(4.07±0.53)个月,两者差异有统计学意义(P<0.05)。清热化积中药能明显减低胰腺癌患者血清CA199水平,改善患者KPS和疼痛症状评分。结论:清热化积法联合HAI/TACE治疗中晚期胰腺癌,可降低胰腺癌患者血清CA199水平,改善患者KPS评分和生存质量,并缓解疼痛症状,延长生存期。
Background and purpose： Pancreatic carcinoma has poor prognosis among most malignant tumors. The clinical efficacy has been made by hepatic arterial infusion chemotherapy and embolization （HAI/TACE） in the treatment of advanced pancreatic cancer. This study aimed to evaluate the therapeutic effects of Qing Re Hua Ji （QRHJ） decoction combined with HAI/TACE treating advanced pancreatic cancer patients and the importance of CA199 level. Methods： From May. 2006 to Jun. 2009, 70 pancreatic cancer patients with stage Ⅲ-Ⅳ hospitalized in the Department of Integrative Oncology, Fudan University Shanghai Cancer Center, were recruited. These patients were divided into two groups randomizedly, QRHJ group and control group. The 3, 6, 9 and 12 months of survival rate of the QRHJ group and control group combined HAI/TACE were calculated respectively. The improvement of symptoms was evaluated before and after treatment. The clinical effects were evaluated using RECIST criteria by B-mode ultrasound and CT or MRI imaging.Results ： There was significant difference of objective response rate between the two groups. The QRHJ group had an advantage of survival rate over control group （1-year survival rate： 31.43% vs 5.71%, mediansurvival： 6.94 months vs 4.24 months）. Toxicity in QRHJ group was not very severe. QRHJ decoction combined with HAI/TACE treatment could prolong the survival rate of pancreatic cancer patient with serum CA199〈500 U/mL, and it could reduce the level of serum CA199. QRHJ decoction also could increase the KPS core of the advanced pancreatic cancer patients and release the symptom of pain. Conclusion： It suggested that QRHJ decoction might benefit the advanced pancreatic cancer patients by stabilizing tumors and prolonging life expectancy, with less side effects and better quality of life. QRHJ decoction can reduce the level of serum CA 199.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2013年第3期218-223,共6页
China Oncology
基金
上海颜德馨中医药基金会课题项目资助(No:05-008)
关键词
清热化积法
中晚期胰腺癌
动脉灌注化疗
栓塞
CA199
Qing Re Hua JI （QRHJ） decoction
Advanced pancreatic cancer
Hepatic artery infusionchemotherapy/transcatheter arterial chemoembolization （HAI/TACE）
CA 199
