據(jù)3月5日《美國醫(yī)學協(xié)會期刊》（JAMA）上的一則研究顯示,，在外科手術(shù)后胰腺癌患者的化學放射療法中增加化療藥物gemcitabine與病患存活情況的改善有關(guān),，但這一改善在統(tǒng)計學意義上不顯著。
美國馬里蘭大學醫(yī)學中心的William F. Regine及其同僚開展了一項評估研究——在fluorouracil化學放射療法（化療加放療）的輔助治療中增加gemcitabine是否能改善病人的存活情況,。這些病患在治療胰腺癌時被切除了一部分的胰腺,。
作者在文章中寫道：“在輔助性的以fluorouracil為基礎(chǔ)的化學放射療法中添加gemcitabine與切除了胰腺癌病患的存活情況改善有關(guān)聯(lián)，但這一改善在統(tǒng)計學意義上并不顯著,。”（來源：EurekAlert!中文版）
生物谷推薦原始出處：
（JAMA）,，2008;299(9):1019-1026，William F. Regine,，Tyvin A. Rich
Fluorouracil vs Gemcitabine Chemotherapy Before and After Fluorouracil-Based Chemoradiation Following Resection of Pancreatic Adenocarcinoma
William F. Regine, MD; Kathryn A. Winter, MS; Ross A. Abrams, MD; Howard Safran, MD; John P. Hoffman, MD; Andre Konski, MD; Al B. Benson, MD; John S. Macdonald, MD; Mahesh R. Kudrimoti, MD; Mitchel L. Fromm, MD; Michael G. Haddock, MD; Paul Schaefer, MD; Christopher G. Willett, MD; Tyvin A. Rich, MD
ABSTRACT
Context Among patients with locally advanced metastatic pancreatic adenocarcinoma, gemcitabine has been shown to improve outcomes compared with fluorouracil.
Objective To determine if the addition of gemcitabine to adjuvant fluorouracil chemoradiation (chemotherapy plus radiation) improves survival for patients with resected pancreatic adenocarcinoma.
Design, Setting, and Participants Randomized controlled phase 3 trial of patients with complete gross total resection of pancreatic adenocarcinoma and no prior radiation or chemotherapy enrolled between July 1998 and July 2002 with follow-up through August 18, 2006, at 164 US and Canadian institutions.
Intervention Chemotherapy with either fluorouracil (continuous infusion of 250 mg/m2 per day; n = 230) or gemcitabine (30-minute infusion of 1000 mg/m2 once per week; n = 221) for 3 weeks prior to chemoradiation therapy and for 12 weeks after chemoradiation therapy. Chemoradiation with a continuous infusion of fluorouracil (250 mg/m2 per day) was the same for all patients (50.4 Gy).
Main Outcome Measures Survival for all patients and survival for patients with pancreatic head tumors were the primary end points. Secondary end points included toxicity.
Results A total of 451 patients were randomized, eligible, and analyzable. Patients with pancreatic head tumors (n = 388) had a median survival of 20.5 months and a 3-year survival of 31% in the gemcitabine group vs a median survival of 16.9 months and a 3-year survival of 22% in the fluorouracil group (hazard ratio, 0.82 [95% confidence interval, 0.65-1.03]; P = .09). The treatment effect was strengthened on multivariate analysis (hazard ratio, 0.80 [95% confidence interval, 0.63-1.00]; P = .05). Grade 4 hematologic toxicity was 1% in the fluorouracil group and 14% in the gemcitabine group (P < .001) without a difference in febrile neutropenia or infection. There were no differences in the ability to complete chemotherapy or radiation therapy (>85%).
Conclusions The addition of gemcitabine to adjuvant fluorouracil-based chemoradiation was associated with a survival benefit for patients with resected pancreatic cancer, although this improvement was not statistically significant.
