切换至 "中华医学电子期刊资源库"

中华普通外科学文献(电子版) ›› 2022, Vol. 16 ›› Issue (06) : 407 -411. doi: 10.3877/cma.j.issn.1674-0793.2022.06.005

论著

白蛋白结合型紫杉醇治疗转移性胰腺癌的疗效观察
宁涓1,(), 王晓燕2, 魏华萍2   
  1. 1. 100080 北京市海淀医院肿瘤血液内科
    2. 101400 北京怀柔医院肿瘤内科
  • 收稿日期:2022-08-18 出版日期:2022-12-01
  • 通信作者: 宁涓
  • 基金资助:
    北京市海淀医院面上项目(BHHMEC-XM-2021-08)

Efficacy of albumin bound paclitaxel in the treatment of metastatic pancreatic cancer

Juan Ning1,(), Xiaoyan Wang2, Huaping Wei2   

  1. 1. Department of Oncology, Haidian Hospital of Beijing, Beijing 100080, China
    2. Department of Oncology, Huairou Hospital of Beijing, Beijing 101400, China
  • Received:2022-08-18 Published:2022-12-01
  • Corresponding author: Juan Ning
引用本文:

宁涓, 王晓燕, 魏华萍. 白蛋白结合型紫杉醇治疗转移性胰腺癌的疗效观察[J/OL]. 中华普通外科学文献(电子版), 2022, 16(06): 407-411.

Juan Ning, Xiaoyan Wang, Huaping Wei. Efficacy of albumin bound paclitaxel in the treatment of metastatic pancreatic cancer[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2022, 16(06): 407-411.

目的

探讨白蛋白结合型紫杉醇治疗吉西他滨为基础的一线化疗失败的转移性胰腺癌的有效性和安全性。

方法

选择2014年1月至2020年7月在北京怀柔医院经穿刺病理确诊为转移性胰腺癌且吉西他滨为基础的一线化疗失败的50例患者,其中对照组25例,采用mFOLFOX6方案治疗;观察组25例,采用白蛋白结合型紫杉醇方案治疗。回顾性分析两组患者的临床特征、治疗方法、近远期疗效及不良反应发生情况。

结果

治疗2周期后,对照组完全缓解(CR)0例,部分缓解(PR)10例,疾病稳定(SD)12例,疾病进展(PD)3例,客观缓解率(ORR)为40.0%,疾病控制率(DCR)为88.0%。观察组CR 0例,PR 12例,SD 11例,PD 2例,ORR为48.0%,DCR为92.0%。两组ORR、DCR差异无统计学意义(χ2=0.325,P=0.569;χ2=0.222,P=0.637)。对照组和观察组中位无进展生存期(PFS)分别为4.2个月(95% CI:3.711~4.692个月)和4.6个月(95% CI:3.765~5.435个月),中位总生存期(OS)分别为7.4个月(95% CI:7.050~7.750个月)和7.9个月(95% CI:7.679~8.121个月),两组PFS和OS差异均无统计学意义(χ2=0.419,P=0.517;χ2=2.978,P=0.084)。观察组的化疗耐受性优于对照组,不良反应主要为嗜中性粒细胞减少(16.0%)、贫血(12.0%)、感觉神经毒性(40.0%)、乏力(20.0%)、肝功能损伤(12.0%)、恶心(8.0%)和腹泻(12.0%),其3、4级不良反应发生率显著低于对照组,差异均有统计学意义(P<0.05)。

结论

对于吉西他滨为基础的一线化疗失败的转移性胰腺癌,白蛋白结合型紫杉醇方案与mFOLFOX6方案疗效相当,且不良反应较低。

Objective

To investigate the efficacy and safety of albumin bound paclitaxel in the treatment of metastatic pancreatic cancer with first-line gemcitabine based chemotherapy failure.

Methods

A total of 50 patients with metastatic pancreatic cancer after first-line gemcitabine based chemotherapy failure in Huairou Hospital of Beijing from January 2014 to July 2020 were divided into two groups according to different treatment regimens. 25 cases in the control group were treated with mFOLFOX6 regimen, while 25 cases in the observation group were treated with albumin bound paclitaxel regimen. The clinical characteristics, treatment methods, short-and long-term effects and adverse reactions of the two groups were analyzed retrospectively.

Results

After two cycles of treatment, there were 0 case of complete remission (CR), 10 cases of partial remission (PR), 12 cases of stable disease (SD), and 3 cases of disease progression (PD), the objective response rate (ORR) was 40.0%, and the disease control rate (DCR) was 88.0% in the control group. In the observation group, there were 0 case of CR, 12 cases of PR, 11 cases of SD and 2 cases of PD, ORR was 48.0%, DCR was 92.0%. There were no significant differences in ORR and DCR between the two groups (χ2=0.325, P=0.569; χ2=0.222, P=0.637). The median progression free survival (PFS) of the control group and the observation group were 4.2 months (95% CI: 3.711-4.692 months) and 4.6 months (95% CI: 3.765-5.435 months), respectively. The median overall survival (OS) was 7.4 months (95% CI: 7.050-7.750 months) and 7.9 months (95% CI: 7.679-8.121 months), respectively. There were no significant differences in PFS and OS of the two groups ( χ2=0.419, P=0.517; χ2=2.978, P=0.084). The chemotherapy tolerance of the observation group was better than that of the control group. The main adverse reactions were neutropenia (16.0%), anemia (12.0%), sensory neurotoxicity (40.0%), asthenia (20.0%), liver function damage (12.0%), nausea (8.0%) and diarrhea (12.0%). The incidence of grade 3 and 4 adverse reactions in the observation group was significantly lower than that in the control group (P<0.05).

Conclusion

Albumin bound paclitaxel regimen is comparable to the mFOLFOX6 regimen in the treatment of first-line resistant metastatic pancreatic cancer and the adverse reactions are low.

表1 两组转移性胰腺癌患者一般资料的比较[例(%)]
表2 两组转移性胰腺癌患者治疗2周期后的短期疗效比较[例(%)]
图1 两组转移性胰腺癌患者的无进展生存期Kaplan-Meier曲线
图2 两组转移性胰腺癌患者的总生存期Kaplan-Meier曲线
表3 两组转移性胰腺癌3级和4级不良反应比较[例(%)]
[1]
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020[J]. CA Cancer J Clin, 2020, 70(1): 7-30.
[2]
Ramanathan RK, Goldstein D, Korn RL, et al. Positron emission tomography response evaluation from a randomized phase Ⅲ trial of weekly nab-paclitaxel plus gemcitabine versus gemcitabine alone for patients with metastatic adenocarcinoma of the pancreas[J]. Ann Oncol, 2016, 27(4): 648-653.
[3]
Golan T, Hammel P, Reni M, et al. Maintenance olaparib for germline BRCA-mutated metastatic pancreatic cancer[J]. N Engl J Med, 2019, 381(4): 317-327.
[4]
Philip PA, Lacy J, Portales F, et al. Nab-paclitaxel plus gemcitabine in patients with locally advanced pancreatic cancer (LAPACT): A multicentre, open-label phase 2 study[J]. Lancet Gastroenterol Hepatol, 2020, 5(3): 285-294.
[5]
Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer[J]. N Engl J Med, 2011, 364(19): 1817-1825.
[6]
Grimaldi S, Terroir M, Caramella C. Advances in oncological treatment: limitations of RECIST 1.1 criteria[J]. Q J Nucl Me Mol Imaging, 2018, 62(2): 129-139.
[7]
Han SY, Kim DU, Seol YM, et al. Comparison of gemcitabine plus nab-paclitaxel and FOLFIRINOX in metastatic pancreatic cancer[J]. World J Clin Cases, 2020, 8(17): 3718-3729.
[8]
Thomas H. IL-6 drives niche formation in pancreatic cancer liver metastasis[J]. Nat Rev Gastroenterol Hepatol, 2019, 16(5): 263.
[9]
刘梦奇,吉顺荣,徐晓武, 等. 2019年胰腺癌研究及诊疗新进展[J]. 中国癌症杂志, 2020, 30(1): 1-10.
[10]
Foschini F, Napolitano F, Servetto A, et al. FOLFIRINOX after first-line gemcitabine-based chemotherapy in advanced pancreatic cancer: A retrospective comparison with FOLFOX and FOLFIRI schedules[J]. Ther Adv Med Oncol, 2020, 12: 1758835920947970.
[11]
Hoy SM. Albumin-bound paclitaxel: A review of its use for the first-line combination treatment of metastatic pancreatic cancer[J]. Drugs, 2014, 74(15): 1757-1768.
[12]
翟鹏涛,李梅,庞宏涛. 吉西他滨联合白蛋白结合型紫杉醇治疗晚期胰腺癌的疗效及安全性[J]. 癌症进展, 2021, 19(6): 619-622.
[13]
唐美月,石宇,王思亮, 等. 白蛋白结合型紫杉醇联合吉西他滨治疗局部进展期胰腺癌的疗效观察[J]. 实用药物与临床, 2016, 19(5): 565-567.
[1] 马中正, 杨云川, 马翔, 周迟, 丁丁, 霍俊一, 徐楠, 崔培元, 周磊. 胰腺癌双硫死亡相关的lncRNA预后模型的构建及免疫反应研究[J/OL]. 中华普通外科学文献(电子版), 2024, 18(05): 368-376.
[2] 罗文斌, 韩玮. 胰腺癌患者首次化疗后中重度骨髓抑制的相关危险因素分析及预测模型构建[J/OL]. 中华普通外科学文献(电子版), 2024, 18(05): 357-362.
[3] 付成旺, 杨大刚, 王榕, 李福堂. 营养与炎症指标在可切除胰腺癌中的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 704-708.
[4] 史成宇, 季晓琳, 田莉莹, 张来香. 腹腔镜胰十二指肠切除术中第14c/d组淋巴结清扫在胰头癌中的临床效果研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(04): 430-433.
[5] 宋小飞, 巫嘉文, 孙阳. 输尿管开口周围膀胱黏膜预离断联合早期膀胱灌注化疗在上尿路尿路上皮癌根治术中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(05): 479-484.
[6] 魏孔源, 仵正, 王铮, 黎韡. 机器人胰腺中段切除后远端胰腺消化道不同重建方式初探[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 295-300.
[7] 郭诗翔, 谭明达, 王槐志. 胰头癌淋巴结清扫再思考[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 625-628.
[8] 张昊, 潘卫东. 胰腺癌新辅助化疗后可切除性评估现状及进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 629-633.
[9] 周倜, 吴嘉, 韩方, 徐林伟, 张宇华. 新辅助治疗时代胰腺癌淋巴结清扫研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 634-639.
[10] 王军华, 王锐炫. 胰腺癌新辅助化疗现状和治疗策略[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 640-643.
[11] 魏妙艳, 徐近. 合并远处转移胰腺癌系统性治疗的梳理和展望[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 644-650.
[12] 罗柳平, 吴萌萌, 陈欣磊, 林科灿. 胰腺全系膜切除在胰头癌根治术中的应用价值[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 651-656.
[13] 张瑜, 姜梦妮. 基于DWI信号值构建局部进展期胰腺癌放化疗生存获益预测模型[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 657-664.
[14] 危用洋, 黄俊甫, 辛万鹏, 易思清, 涂书举, 方康, 李勇, 肖卫东. 三种术式治疗胰腺颈体部良性或低度恶性肿瘤的临床疗效分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 515-519.
[15] 杨秀君, 崔梦莹, 刘水, 盛基尧, 张丹. 基于SEER数据库胰头部胰腺神经内分泌癌患者预后列线图构建与验证[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(04): 520-525.
阅读次数
全文


摘要