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Purpose: Pancreatic cancer has become one of the common digestive system, at home and abroad, the incidence rate showed an increasing trend. Because of its short duration, rapid development, insidious onset, early detection is difficult, so the prognosis is poor. Early diagnosis and treatment of a clinical facing a major problem, gemcitabine drug of choice for the treatment of pancreatic cancer, can improve the patient's quality of life, but gemcitabine-based combination chemotherapy is due to a single-agent chemotherapy remains controversial. In this paper, First Affiliated Hospital of Dalian Medical University, Dalian City, three homes and some advanced pancreatic cancer patients for clinical analysis, and gemcitabine single-agent chemotherapy and combination chemotherapy for an analysis in order to improve the diagnosis and treatment of pancreatic cancer. Methods: A retrospective analysis of Affiliated Hospital of Dalian Medical University, January 2002 - December 2009 treated patients with advanced pancreatic cancer and some Third People's Hospital of Dalian City in patients with advanced pancreatic cancer were 60 cases of clinical data and telephone follow-up results, using SPSS11.5 software for analysis, statistical processing, and combined to make a clinical analysis of relevant literature. Of which 45 cases of systemic chemotherapy in patients with advanced pancreatic cancer clinical data, analyze it. Gemcitabine monotherapy group of 17 patients, a dose of 1 000mg/m2, d1, 8, three weeks of a cycle. Gemcitabine treatment group 28 cases, chemotherapy regimens including gemcitabine 1000mg/m2, d1, 8, were combined: (1) fluorouracil 425-600mg/m2, infusion or continuous intravenous infusion, d1-5; (2) cisplatin 60-75mg/m2, 3-4 day intravenous infusion; (3) oxaliplatin 85-130mg/m2, d1, intravenous infusion; (4) capecitabine 1000mg/m2, orally twice daily, d1-14. 21-day cycle. Using Kaplan-Meier survival curve analysis of survival of patients and to compare the clinical efficacy between the two groups, the median time to disease progression, median survival time and adverse reactions. Results: In 60 cases of pancreatic cancer patients, 39 males and 21 females, male to female ratio of 1.86:1, the youngest 36 years old, maximum 78 years, with a median age of 60 years old. Tumor: tumor in the pancreatic head in 33 cases, accounting for 55%, 27 cases of pancreatic body and tail, accounting for 45%. 60 patients: smoking (greater than or equal to 20 cigarettes / day * 10 years) 24 cases (60%), drinking 16 cases (26.7%). There cholecystitis, appendicitis and other surgical history of seven cases, accounting for 11.67%, a history of diabetes in 8 cases (13.3%). The three cases have a history of pancreatitis, accounting for 5%. Admission, the main clinical manifestations and symptoms include: abdominal pain, the most common, accounting for 83%, followed by weight loss (63%), anorexia (53%), fatigue (38%), abdominal distension (32%), jaundice (25% ), back pain (23%), nausea and vomiting (18%), hyperglycemia (18%), clay it (8%), abdominal mass (7%), pruritus (5%) and fever (3%) . Among patients with painless jaundice pancreatic cancer accounted for 25%. Laboratory tests: liver function abnormalities (including alanine aminotransferase, aspartate aminotransferase, GGT, ALP and other elevated) with 17 cases, accounting for 28.3%. Anemia in patients with 11 cases, accounting for 18.3%. Tumor marker examination: 60 patients with metastatic pancreatic cancer patients, 51 cases have CA1 99 increased, and at least 2 times higher than 31 patients have elevated CA125, 26 cases have elevated CEA. The positive rate of CA199 91.1% gt; CA12572.1% gt; CEA 44.8%. Imaging: 60 patients, 32 patients underwent ultrasonography, 19 patients met the diagnosis of pancreatic cancer, the positive rate of 59.4%. 44 routine CT scan or enhanced CT, 40 cases of pancreatic cancer diagnosed in line, the positive rate was 90.9%. There are 31 routine MRI, 30 cases diagnosed, the positive rate 96.77%. Prognosis: onset to treatment time, weight loss, back pain and whether receiving chemotherapy and prognosis, whereas age, whether elevated transaminase and prognosis. Patients undergoing chemotherapy gemcitabine monotherapy group and clinical benefit rate is improved, but the clinical efficacy between the two groups, disease control rate, median survival time was not statistically significant. Conclusions: 1. Pancreatic cancer men than women, the peak incidence at 50 years of age. Unknown etiology, smoking and pancreatic cancer pathogenesis. 2 pancreatic cancer clinical manifestations were abdominal pain, weight loss, loss of appetite, fatigue, abdominal distension, jaundice. 3 tumor markers CA125 and CA199 positive rate of CEA. CT and MRI diagnosis was significantly higher than ultrasound. 4 weight loss, back pain, onset to treatment time, whether to accept the prognosis of pancreatic cancer chemotherapy, age, elevated aminotransferases and prognosis. 5 gemcitabine combination chemotherapy with gemcitabine monotherapy in the treatment of advanced pancreatic cancer, compared the efficacy, clinical benefit rate, median survival were similar.
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