| Objective:Pancreatic cancer is one of the most common malignant digestive tumors, either at home or abroad, its morbidity is increasing year by year. Its prognosis is very bad because of short course, hiding beginning and fast progression. Early diagnosis and treatment is a difficult problem for pancreatic cancer. This article explores the clinical characteristics of the 60 patients with pancreatic cancer of the No.1 Hospital Affiliated to Dalian Medical University and Dalian No.3 Hospital, and analyses 45 pancreatic cancer patients'chemotherapy, and compares the efficacy of GEM-based combination therapy and gemcitabine alone on advanced pancreatic cancer.Methods:60 cases of pancreatic cancer were reviewed and analyzed retrospectively, which were from the No.1 Affiliated Hospital of Dalian Medical University and Dalian No.3 hospital during Jan 2002 to Jun 2009. using the software of SPSS 11.5 for statistics.45 cases among the 60 cases of pancreatic cancer were reviewed and analyzed retrospectively, which were from the No.1 Affiliated Hospital of Dalian University during Jan 2002 to Jun 2009 and some cases of Dalian No.3 Hospital. Of the 45 cases, 17 were treated with gemcitabine(1000mg/m2) alone weekly for two weeks followed by one week's rest;28 patients were treated with gemcitabine (1000mg/m2) weekly for two weeks plus 5-Fu(425-600mg/m2) as bolus at day 1-5 or 120-hour infusion every 21 days, or DDP (60-75mg/m2) divided into 3-4 days every 21 days, or oxaliplatin (85-130mg/m2) at Day 1 every 21 days, or capicitabine (1000mg/m2) twice a day at Day 1-14 every 21 days, respectively. The survival was analyzed by Kaplan-Meier method. Median time to progression (mTTP), clinical benefit response (CBR), disease control rate, median overall survival (mOS) and toxicity were assessed according to World Health Organization criteria.Result:Of the 60 cases of pancreatic cancer,39 were men and 21 were women. The ratio between males and females was 1.86 to 1. The youngest was 36 years old, while the oldest was 78.The median was 60. Its morbidity increases year by year. The positions of tumors in 60 cases were different, including 33 cases (55%) in the head and 27 cases (45%) in the body and tail. Epidemiological investigation:24 out of 60 cases (40%) were smoking (≥20 pieces per day for 10 years), and 16 cases (26.7%) were drinkers.7 cases (11.67%) had an operation for cholecystitis, appendicitis, and so on.8 cases (13.3%) had diabetes mellitus and 3 cases (5%) had pancreatitis. The clinical symptoms and signs included abdominal pain (83%), inappetency (53%), feebly (38%), abdominal distension (32%), jaundice (25%), backache (23%), nausea (18%), hyperglycemia (18%), clay will (8%), abdominal mass (7%), pruritus (5%), and fever (3%). Lab examination:17 cases (28.3%) had elevated transaminase, and 11 cases (18.3%) had anemia. Marker:Of the 60cases, the positive rate of CA199, CA125, and CEA were 91.1%,72.1%, and 44.8% respectively. Imaging:The positive rate of BUS, CT, and MRI were 59.4%,90.9%, and 96.77%. Analysis of prognosis:Time from onset to diagnosis, weight loss, backache, and chemotherapy were related to prognosis of pancreatic cancer. The rate of CBR both in GEM-combination group and GEM alone group was lengthened. But there were no significant differences in disease control rate, mOS, CBR, and adverse events between the two groups (all P>0.05).Conclusions1. The morbidity of pancreatic cancer is influenced by many factors. The number of men's is more than women's. The peak age is after 50 years old. Smoking is related to its morbidity.2. The main symptoms are abdominal pain, weight loss, inappe-tency,feebly, abdominal distension, and jaundice.3. The positive rate of CA199 is higher than CEA and CA125. CT and MRI's positive rate is higher than BUS.4. Time from onset to diagnosis, weight loss, backache, and chemotherapy is related to pancreatic cancer's prognosis.5. GEM-combination regimens and GEM alone have similar efficacy, and lead to similar clinical benefit response and mOS for the patients with advanced pancreatic cancer.
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