晚期原发性胆囊癌的化疗

目的:回顾性分析比较联合化疗及最佳支持治疗对晚期原发性胆囊癌的临床受益反应率及生存期。方法:将39例晚期原发性胆囊癌的患者非随机地分成3组,其中FAP组12例;GFO组8例;BSC组19例。化疗组每3～4周重复1次,治疗2周期后进行疗效评价,采用KaplanMeier法分析患者生存期,Logrank法进行检验。结果:FAP组的客观有效率16.7%(2/12),GFO组为25.0%(2/8),两组相比无显著性差异(P>0.05)。临床受益反应(CBR)率三组分别为25.0%、37.5%和26.3%;如将FAP组和GFO组合并成化疗组,化疗组与BSC组无显著性差异(P>0.05)。化疗组和BSC组的平均生存时间分别为6.7月和5.2月,两组用Logrank检验后无显著性差异(P>0.05)。结论:对于晚期原发性胆囊癌患者,应用FAP和GFO方案化疗并不优于最佳支持治疗。

Chemotherapy in the treatment of advanced gallbladder cancer

Objective:To compare the clinical benefit response(CBR) and survival time of chemotherapy and best supportive care (BSC) for advanced gallbladder cancer(GBC).Methods:Of 39 GBC patients,12 received 5-fluorouracil(5-FU) doxorubicin(ADM) cisplatin(DDP) ( FAP group),8 received gemcitabine(GEM) 5-fluorouracil oxaliplatin (OXA)(GFO group) and 19 received best supportive care(BSC group). Chemotherapy was repeated every 3 weeks. Patients were evaluated for response every two cycles of treatment. Survival rate was calculated by the Kaplan-Meier method and tested by Log-rank test.Results:The overall response rates and CBRs were 2/12(16.7%) and 25.0% in FAP group,2/8(25.0%) and 37.5% in GFO group.There was no significant difference in two groups(P>0.05).In BSC group CBRs was 26.3%.FAP group and GFO group were combined into the chemotherapy group(Cx group).The median survival time was 6.7 months in Cx group and 5.2 months in BSC group. There was no significant difference by Log-rank test in two groups(P>0.05).Conclusion:To the GBC patients,chemotherapy is not prior to best supportive care.