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目的:总结国内外吉西他滨固定剂量率(FDR)输注治疗胰腺癌的研究进展,探讨其临床应用前景。方法:检索数据库PubMed、CNKI、万方及中国生物医学文献数据库2000-01-2011-12文献,以“吉西他滨、固定剂量率、胰腺癌”等为关键词,不限定发表时间和语言;纳入研究FDR吉西他滨的基础研究、临床试验、综述和meta分析,共检索到文献253篇。符合纳入标准的文献26篇。纳入标准:1):比较吉西他滨FDR输注与标准输注的临床研究和Meta分析;2):吉西他滨FDR输注药理学的研究。结果:药理学研究已证明FDR吉西他滨可使细胞内有活性的吉西他滨三磷酸盐达到最佳的蓄积速度。随机对照试验发现,相较于标准输注,FDR可以改善胰腺癌患者的生存结果,但血液系统毒性反应发生率较高。近年来的一些临床试验中,FDR吉西他滨单药或者联合其他化疗药物均有较好的生存结果,而且使用较小剂量时血液系统毒性也相应减少。结论:FDR吉西他滨可以提高胰腺癌患者的生存期,同时血液系统毒性反应发生率较高。
Objective: To summarize the research progress of fixed dose rate (FDR) infusion of gemcitabine at home and abroad for the treatment of pancreatic cancer and to explore its clinical application prospects. METHODS: The databases of PubMed, CNKI, Wanfang and Chinese Biomedical Literature Database 2000-01-2011-12 were searched, with the key words of “gemcitabine, fixed dose rate, pancreatic cancer” and so on, without limitation on the time and language of publication. Included in the study of FDR gemcitabine basic research, clinical trials, reviews and meta-analysis, a total of 253 articles were retrieved. Twenty-six literatures met the inclusion criteria. Inclusion criteria: 1) Clinical and Meta-analysis comparing gemcitabine with FDR infusion and standard infusion; and 2) Study of gemcitabine FDR infusion pharmacology. Results: Pharmacological studies have demonstrated that FDR gemcitabine maximizes the rate of intracellular accumulation of gemcitabine triphosphate. In a randomized controlled trial, FDR improved survival in patients with pancreatic cancer compared with standard infusion, but the incidence of hematologic toxicities was higher. In recent years, some clinical trials, FDR gemcitabine alone or in combination with other chemotherapy drugs have better survival results, and the use of smaller doses of the corresponding reduction in blood system toxicity. Conclusion: FDR gemcitabine can improve the survival of patients with pancreatic cancer, while the higher incidence of hematological toxicity.