The Relative Factors Affecting The Prognosis Of Advanced Pancreatic Carcinoma

Objective: To study the relative factors affecting the prognosis of advanced pancreatic carcinoma with Cox proportional hazard model, and effectiveness of radiotherapy combined with palliative operation. Methods: 109 patients with unresectable and advanced pancreatic carcinoma admitted from Mar.2004 to Feb. 2007 were analyzed with Cox proportional hazard model. 55 cases were treated by the supportive care; 26 cases by palliative operation and 28 cases by palliative operation combined with radiotherapy, respectively. Radiotherapy including iodine125 seed implantation(16 cases) and 3D conformal radiotherapy(12 cases).χ2 test for pain relieving rate pre- and post- radiotherapy; t'test for CA-199 levels before and after the radiotherapy. Results:The major factors affecting prognosis was treatment. Palliative operation combined with radiotherapy could reduce the death risk 7.83 times than other treatments. Among the 21 patients who suffered pain before radiotherapy, complete response was obtained in 76.19%(16/21), partial response in 14.29%(3/21) which is significantly higher than that of other two groups (P=0.0001). The level of CA-199 (21.2±4.5u/ml) after radiotherapy was significantly lower than that of before radiotherapy(231.6±32.9u/ml) (F=53.4523, P=0.0000).The median survival time in combined group was 42.3 weeks, which was significantly longer than that of other two groups (17.1 weeks, 9.5weeks). Conclusion : Palliative operation combined with radiotherapy would improve the prognosis of advanced pancreatic carcinoma. It does show some therapeutic effects for advanced pancreatic carcinoma, in terms of pain relieving rate, CA-199 levels and median survival time.