Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer
Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer
复制标题
DOI：
10.1093/oxfordjournals.annonc.a010676
复制
发表时间：
1996-08-01
影响因子：
50.5
通讯作者：
Svensson, C
中科院分区：
文献类型：
--
作者：
Glimelius, B;Hoffman, K;Svensson, C
背景资料：在某些胰腺癌和胆管癌患者中，化疗可以缓解肿瘤相关症状，改善生活质量，并可能延长生存期。尽管广泛使用这种治疗方式，但这些改善的程度尚不完全清楚。本研究的目的是估计任何增益的数量和质量的生活中产生的化疗患者胰腺癌和胆道cancer.Patients和方法：1991年1月至1995年2月，90名符合条件的胰腺癌或胆道癌患者被随机分配到化疗，除了最好的支持性治疗或最好的支持性治疗。如果支持性措施未导致缓解，则允许后一组进行化疗。化疗是序贯5-氟尿嘧啶/甲酰四氢叶酸联合依托泊苷（FELv），或在老年和性能差的患者，相同的方案没有依托泊苷（FLv）。结果：化疗组患者QLQ-C30量表平均分较最佳支持治疗组改善更频繁/恶化更少。化疗组患者的生活质量改善或延长至少4个月的比例（36%，17/49）高于最佳支持治疗组（10%，4/41，P< 0.01）。化疗组总生存期明显延长（中位6个月对2.5个月，P < 0.01）。此外，随机接受化疗的患者的质量调整生存时间更长（中位数4 vs 1个月，P< 0.01）。结论：结果表明，化疗可以增加晚期胰腺癌和胆管癌的生活数量和质量。然而，受益于治疗的患者数量仍然有限;因此，治疗前必须仔细选择，治疗期间必须密切监测。
Background: In certain patients with pancreatic and biliary cancer, chemotherapy may relieve tumour-related symptoms, improve quality of life and possibly prolong survival. The extent of these improvements is not completely known in spite of the extensive use of this treatment modality. The aim of this study was to estimate any gain in the quantity and quality of life produced by chemotherapy in patients with pancreatic and biliary cancer.Patients and methods: Between January 1991 and February 1995, 90 eligible patients with pancreatic or biliary cancer were randomized to either chemotherapy in addition to best supportive care or to best supportive care. Chemotherapy was allowed in the latter group if the supportive measures did not lead to palliation. Chemotherapy was either sequential 5-fluorouracil/leucovorin combined with etoposide (FELv) or, in elderly and poor performance patients, the same regimen without etoposide (FLv). Quality of life was evaluated with the EORTC-QLQ-C30 instrument.Results: Mean scale scores in the QLQ-C30 improved more often/deteriorated less frequently in the chemotherapy group than in the best supportive care group. More patients in the chemotherapy group (36%, 17/49) had an improved or prolonged high quality of life for a minimum period of 4 months compared to those in the best supportive care group (10%, 4/41, P< 0.01). Overall survival was significantly longer in the chemotherapy group (median 6 vs. 2.5 months, P < 0.01). Also, the quality-adjusted survival time was longer for patients randomized to chemotherapy (median 4 vs. 1 months, P< 0.01). The effects were seen both in pancreatic and biliary cancer.Conclusions: The results show that chemotherapy can add to both quantity and quality of life in advanced pancreatic and biliary cancer. The number of patients who benefit from treatment is, however, still Limited; for this reason careful selection before, and close monitoring during, treatment are necessary.