胰腺癌治疗进展.ppt

17个国家的159个中心，1088例 ESPAC-3 Study Design RANDOMIZE Ann Surg Oncol. 2011 May;18(5):1319-26. 5-FU＋CF 组 (551例) Gemcitabine (537例) folinic acid 20 mg/m2 followed ， fluorouracil 425 mg/m2 gemcitabine 1000 mg/m2 Adjuvant Therapy of Pancreatic Cancer: Beyond Gemcitabine Highlights from the 2011 ASCO Gastrointestinal Cancers Symposium. San Francisco, CA, USA.January 20-22, 2011 5-FU＋CF 吉西他滨 P 中位生存期（M) 23 23.6 NS 1yr(%) 79 80 2yr(%) 48 49 PFS(m) 14 14 1yr(%) 56 61 2yr(%) 31 30 ESPAC-3结果 Conclusion:The overall survival was similar on both arms, hence showing that gemcitabine is not superior to 5-FU in adjuvant setting. However, safety and dose intensity favored gemcitabine in this study 显著延长生存时间：提高生存3.5－5个月 最佳支持治疗的中位生存时间：2.25月－3.75月 含健择化疗的中位生存时间：5.7月－9月 化疗可提高病人生存期和改善生活质量； 局部晚期胰腺癌化疗 Mallinson CN. Chemotherapy in pancreatic cancer: results of a controlled, prospective, randomised, multicentre trial 1980 Andersen JR. A controlled trial of combination chemotherapy with 5-FU and BCNU in pancreatic cancer 1981(8) Frey C. Randomized study of 5-FU and CCNU in pancreatic cancer: report of the Veterans Administration Surgical Adjuvant Cancer Chemotherapy Study Group 1981(1) Palmer KR. Chemotherapy prolongs survival in inoperable pancreatic carcinoma 1994(6) Glimelius B. Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer 1996(6) 药物 有效率（%） 5-FU 16~28 MMC 21~33 Streptozotocin 27 ADM