Retrospective Comparative Study Of AG Regimen And GS Regimen In The Treatment Of Advanced Pancreatic Cancer

Objective:To analyze the clinical effect of gemcitabine respec-tively combined with nab-paclitaxel and S-1 in the treatment of advanced pancreatic cancer.Methods:A total of 53 patients with advanced pancreatic cancer admitted to the Xiangya 3^rdhospital were enrolled between February2018 and October 2021,depending on the chemotherapy regimen,they were divided into AG group（27 cases,gemcitabine combined with nab-paclitaxel）and GS group（26 cases,gemcitabine combined with S-1）.The short-term effects,survival,quality of life at different time points,levels of tumor markers,clinical benefit,and toxic reactions during treatment were compared between the two groups of patients after 2 courses of chemotherapy.Results:The objective response rate（ORR）,disease control rate（DCR）,median prgression-free survival（m PFS）,median overall survival（m OS）and 1-year survival rate of the AG group were higher than those of the GS group（40.74%vs26.92%,74.70%vs53.85%,8.5vs5.3 months,12.4vs9.2months,51.85%vs34.61,P<0.05）.There was no significant difference in ORR,DCR,mpfs,mos and 1-year survival rate between AG group and GS group in liver metastasis subgroup（50.00%vs41.67%,87.50%vs83.33%,8.7vs6.9months,12.1vs10.8 months,56.25%vs50.00,P>0.05）.The quality of life score in each course of treatment in the AG group was higher than that in the GS group（84.32±8.52vs73.27±7.76,89.47±9.04vs80.14±8.43,P<0.05）.The quality of life scores in each course of treatment in the AG group were higher than those in the GS group in the liver metastasis subgroup（85.42±8.22vs76.37±7.66,89.23±8.86vs85.42±8.22,P<0.05）.The levels of serum tumor markers CA19-9,CEA and CA125 in the AG group after 2 courses of chemotherapy were lower than those in the GS group（31.75±3.83vs43.29±4.42KU/L,4.31±0.52vs5.87±0.63ng/ml,53.27±5.69vs69.51±7.14μg/L,P<0.05）.The levels of serum tumor markers CA19-9,CEA and CA125 in the liver metastases subgroup after 2 courses of chemotherapy in the AG group were not significantly different from those in the GS group（42.25±3.56vs44.39±4.68KU/L,5.16±0.42vs5.27±0.33ng/ml,64.27±5.33vs67.21±6.14μg/L,P>0.05）.The clinical benefit rate of AG group after two courses of chemotherapy was higher than that of GS group（51.85%vs34.62%,P<0.05）.The clinical yield of AG group was higher than that of GS group in liver metastases subgroup（62.50%vs42.67%,P<0.05）.The main toxic and side effects after chemotherapy in patients with advanced pancreatic cancer and liver metastases included neutropenia and leukopenia,hepatotoxicity,fatigue,nausea and vomiting,diarrhea,etc.There was no significant difference in the incidence rates（P>0.05）.Conclusion:1.Compared with the GS regimen,the AG regimen may have better short-term effects,longer survival,higher quality of life,lower serum tumor marker levels,higher clinical yield,and no significant difference in safety in the treatment of advanced pancreatic cancer.2.The AG regimen and the GS regimen may have no significant difference in short-term effects,survival,serum tumor marker levels,and safety in the treatment of patients with advanced pancreatic cancer liver metastases;In terms of improving the quality of life and clinical yield,the AG regimen may be better.