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目的探讨辅助治疗在Ⅱ期胰腺癌治疗中的作用。方法回顾分析所收治的139例患者的临床资料,随访生存期并进行生存分析。结果 139例患者总体1,3,5年生存率分别为40%,6%,3%,中位生存时间279d。其中根治性切除组、短路或探查手术组和未手术组中位生存时间分别为390d,270d和132d。全组行辅助治疗和未辅助治疗者中位生存时间为399d和210d。根治切除术后辅助治疗并不能明显延长患者生存期或降低肝转移率(P>0.05);对未根治切除患者(包括短路或探查手术组、未手术组)辅助治疗可显著延长生存期(P<0.05),但静脉化疗、放疗、介入化疗和联合方案间生存率差异无统计学意义(P>0.05);以吉西他滨为基础方案与5-FU为基础方案比较,以及吉西他滨联合铂类或卡培他滨较与吉西他滨单药比较,生存率差异均无统计学意义(P>0.05)。结论根治切除手术后,可结合患者自身状况推荐适当的辅助治疗;对未根治性切除的Ⅱ期胰腺癌,应积极开展以化、放疗为主的综合治疗,吉西他滨联合铂类或卡培他滨疗效相对较好。
Objective To explore the role of adjuvant therapy in the treatment of stage Ⅱ pancreatic cancer. Methods Retrospective analysis of the clinical data of 139 patients were followed up for survival and survival analysis. Results The overall 1,3-year and 5-year survival rates of 139 patients were 40%, 6% and 3%, respectively. The median survival time was 279 days. The median survival time of radical resection group, short circuit or exploration operation group and non-operation group were 390d, 270d and 132d respectively. The median survival time of the whole group with adjuvant and non-adjuvant therapy was 399 days and 210 days. Radical resection postoperative adjuvant therapy does not significantly prolong the survival time or reduce the rate of liver metastasis (P> 0.05); adjuvant treatment of patients without radical resection (including short circuit or exploration operation group, non-operation group) can significantly prolong survival (P <0.05). However, there was no significant difference in the survival rate between intravenous chemotherapy, radiotherapy, interventional chemotherapy and the combination regimen (P> 0.05). Compared with 5-FU based gemcitabine-based regimen and gemcitabine combined with platinum or card Pecataban compared with gemcitabine monotherapy, the difference was not statistically significant (P> 0.05). Conclusion Radical resection surgery can be combined with the patient’s own condition recommended appropriate adjuvant therapy; for non-radical resection of stage Ⅱ pancreatic cancer, should actively carry out chemotherapy, radiotherapy-based comprehensive treatment, gemcitabine combined with platinum or capecitabine The effect is relatively good.