[1]李国平,龚高全,王建华,等.不可切除的胰腺癌TAI/TACE治疗后回顾性生存分析[J].介入放射学杂志,2015,(02):118-123.
 LI Guo ping,GONG Gao quan,WANG Jian hua,et al.Retrospective survival analysis of patients with unresectable pancreatic carcinomas after receiving transarterial infusion chemotherapy and transarterial chemoembolization treatment[J].journal interventional radiology,2015,(02):118-123.
点击复制

不可切除的胰腺癌TAI/TACE治疗后回顾性生存分析 ()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2015年02期
页码:
118-123
栏目:
肿瘤介入
出版日期:
2015-02-25

文章信息/Info

Title:
Retrospective survival analysis of patients with unresectable pancreatic carcinomas after receiving transarterial infusion chemotherapy and transarterial chemoembolization treatment
作者:
李国平 龚高全 王建华 颜志平 陈 颐 程洁敏 刘凌晓 王小林
Author(s):
LI Guo ping GONG Gao quan WANG Jian hua YAN Zhi ping CHEN Yi CHENG Jie min LIU Ling xiao WANG Xiao lin.
Department of Interventional Therapy, Zhongshan Hospital, Fudan University, Shanghai 200032, China
关键词:
【关键词】 胰腺癌 介入治疗 中位生存期 生存分析
文献标志码:
A
摘要:
【摘要】 目的 通过对不可切除的胰腺癌患者159例经TAI/TACE治疗后的回顾性生存分析,评估影响胰腺癌介入治疗后生存期的因素。方法 收集并分析159例胰腺癌患者的TAI/TACE治疗病史资料,并对影响胰腺癌患者TAI/TACE治疗后生存期的因素和治疗模式进行单因素及COX模型多因素分析。结果 159例患者总随访中位生存期(mST)为10.32个月,总的介入治疗后mST为8.11个月,总1年累积生存率27.0%,2年累积生存率11.0%,3年累积生存率2.0%,5年累积生存率为0.6%。根据临床反应率(CBR)评估判定介入治疗后能缓解症状的介入次数平均值为2.6次。单因素分析显示影响胰腺癌介入治疗后MST的主要因素有:初次介入治疗前CA19 9值,及其术后变化,初次介入前KPS评分,初次介入前症状,介入治疗前肝功能分级,介入治疗前有无手术史,介入治疗次数。而年龄,性别,初次介入前血红蛋白值,肿瘤分期(Ⅱ~Ⅲ期与Ⅳ期),初次介入时CEA的值,初次介入前后CEA的变化,治疗药物(是否含吉西他滨联合奥沙利铂),治疗方案(TAI/TACE),术前是否存在糖尿病,肿瘤部位(是否为胰头部),病理是否为导管腺癌,均显示差异无明显统计学意义。多因素分析显示对介入治疗后生存期有影响的独立因素是:开始介入治疗时肝功能分级,初治时KPS评分,有无原发灶手术切除史。结论 TAI/TACE对于胰腺癌患者在改善患者症状和延长中位生存期方面有一定的治疗作用,介入治疗后生存期与患者的体力状态,存在症状和有无早期手术治疗有关。

参考文献/References:

[1] Siegel R, Naishadham D, Jemal A. Cancer statistics[J]. CA Cancer J Clin, 2012, 62: 10 29.
[2] Huguet F, Girard N, Guerche CS, et al. Chemoradiotherapy in the management of locally advanced pancreatic carcinoma: a qualitative systematic review[J]. J Clin Oncol, 2009, 27: 2269 2277.
[3] Davis JL, Pandalai P, Ripley RT, et al. Regional chemotherapy in locally advanced pancreatic cancer: RECLAP trial[J]. Trials, 2011, 12: 129.
[4] Brown DB, Narayanan G. Interventional radiology and the pancreatic cancer patient[J]. Cancer J, 2012, 18: 591 601.
[5] Saif MW. Pancreatic neoplasm in 2011: an update[J]. JOP, 2011, 12: 316 321.
[6] Tsimberidou AM, Leick MB, Lim J, et al. Dose finding study of hepatic arterial infusion of oxaliplatin based treatment in patients with advanced solid tumors metastatic to the liver[J]. Cancer Chemother Pharmacol, 2013, 71: 389 397.
[7] Hong GB, Zhou JX, Sun HB, et al. Continuous transarterial infusion chemotherapy with gemcitabine and 5 Fluorouracil for advanced pancreatic carcinoma[J]. Asian Pac J Cancer Prev, 2012, 13: 2669 2673.
[8] 程永德, 程英升, 颜志平, 等. 常见恶性肿瘤介入治疗指南[M]. 北京: 科学出版社, 2013: 147 153.
[9] Jin C, Yao L, Long J, et al. Effect of multiple phase regional intra arterial infusion chemotherapy on patients with resectable pancreatic head adenocarcinoma[J]. Chin Med J (Engl), 2009, 122: 284 290.
[10] Tanaka T, Sho M, Nishiofuku H, et al. Unresectable pancreatic cancer: arterial embolization to achieve a single blood supply for intraarterial infusion of 5 fluorouracil and full dose Ⅳ gemcitabine[J]. Am J Roentgenol, 2012, 198: 1445 1452.
[11] Azizi A, Naguib NN, Mbalisike E, et al. Liver metastases of pancreatic cancer: role of repetitive transarterial chemoembolization(TACE) on tumor response and survival[J]. Pancreas, 2011, 40: 1271 1275.
[12]洪国斌, 周经兴, 许林锋, 等. 中晚期胰腺癌介入治疗与外周静脉化疗疗效比较的META分析[J]. 实用放射学杂志, 2004, 20: 350 353.
[13] Triano LR, Chang BW, Saif MW. New developments in the treatment of locally advanced pancreatic cancer. Highlights from the 45th ASCO annual meeting. Orlando, FL, USA. May 29 June 2, 2009[J]. JOP, 2009, 10: 366 372.
[14] Morak MJ, van der Gaast A, Incrocci L, et al. Adjuvant intra arterial chemotherapy and radiotherapy versus surgery alone in resectable pancreatic and periampullary cancer: a prospective randomized controlled trial[J]. Ann Surg, 2008, 248: 1031 1041.
[15]刘凌晓, 姬 巍, 王建华, 等. 胰腺癌肝转移患者综合性介入栓塞治疗生存情况的回顾性分析[J]. 复旦学报: 医学版, 2011, 38: 101 106.
[16] Haas M, Heinemann V, Kullmann F, et al. Prognostic value of CA 19 9, CEA, CRP, LDH and bilirubin levels in locally advanced and metastatic pancreatic cancer: results from a multicenter, pooled analysis of patients receiving palliative chemotherapy[J]. J Cancer Res Clin Oncol, 2013, 139: 681 689.
[17] Andersen DK. Diabetes and cancer: placing the association in perspective[J]. Curr Opin Endocrinol Diabetes Obes. 2013, 20: 81 86.
[18] Bao B, Wang Z, Li Y, et al. The complexities of obesity and diabetes with the development and progression of pancreatic cancer[J]. Biochim Biophys Acta, 2011, 1815: 135 146.

相似文献/References:

[1]许成钊,周祝谦,张经建,等.抗癌混悬乳剂微型电动制备机的研制及临床应用[J].介入放射学杂志,1992,(01):55.
[2]董永华,林贵.肝癌介入治疗对靶血管损害的影像学评价及预防[J].介入放射学杂志,1992,(01):17.
[3]王骏,李成朗,李桂清,等.经股动脉插管行选择性锁骨下动脉X线造影技术[J].介入放射学杂志,1993,(01):35.
[4]贾雨辰,刘琦,叶华,等.原发性肝癌不同介入治疗方法疗效的比较研究(附468例分析)[J].介入放射学杂志,1993,(01):5.
[5]王颂章,曹钦昊,魏崇健,等.肝癌动门脉短路的X线诊断与介入治疗[J].介入放射学杂志,1993,(01):9.
[6]李麟荪.为我国介入放射学事业的发展而努力[J].介入放射学杂志,1993,(01):3.
[7]王麟川,李文元,缪万祥,等.贲门癌的术前介入治疗的方法[J].介入放射学杂志,1994,(01):27.
[8]谭士岭,董明风.介入性放射学工作在基层医院的开展[J].介入放射学杂志,1994,(03):179.
[9]詹迎江,程永德,张正国,等.保尔佳动脉灌注治疗恶性肿瘤的初步研究[J].介入放射学杂志,1994,(03):184.
[10]周沛林,杨凤生,李向前,等.恶性胸水的介入放射治疗6例[J].介入放射学杂志,1994,(03):162.
[11]吴普照,张跃伟. 胰腺癌综合性介入治疗进展[J].介入放射学杂志,2014,(05):452.
 WU Pu- zhao,ZHANG Yue- wei.. Comprehensive interventional therapy for pancreatic cancer: current progress[J].journal interventional radiology,2014,(02):452.
[12]徐蓓蓓,鲁 东,吕维富,等.125I粒子植入联合区域性动脉灌注化疗对中晚期胰腺癌的临床疗效[J].介入放射学杂志,2022,31(08):770.
 XU Beibei,LU Dong,LYU Weifu,et al.Clinical efficacy of 125I seed implantation combined with regional intraarterial infusion chemotherapy in the treatment of advanced pancreatic cancer[J].journal interventional radiology,2022,31(02):770.

备注/Memo

备注/Memo:
(收稿日期:2014-04-22)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2015-02-16