摘要
目的评价术中放疗（IORT）在局部晚期胰腺癌综合治疗中的价值。方法2007年1月至2009年12月中国医学科学院肿瘤医院收治的、经组织细胞学证实、不可切除的局部晚期胰腺癌65例，随机分为IORT组及对照组（IORT组31例，对照组34例）、进行前瞻性研究。IORT组采用术中放疗加内引流／剖腹探查手术治疗；对照组仅行内引流／剖腹探查治疗。评价两组的术中和术后的不良事件、近期毒副反应、疼痛缓解情况、肿瘤标志物下降情况和远期生存期情况。结果两组手术时间（205．2、173．32rain），术中出血（178．61、162．38ml，P=0．081）等指标及术后恢复情况差异无统计学意义；术后血液毒性、疼痛缓解、CAl9-9IORT组下降明显（术后2周两组分别为（388．9±31．2）U／ml和（508．0±29．8）U／ml，术后1个月分别为（356．7±41．3）U／ml和（566．0±32．1）U／ml、生存期差异均有统计学意义（P=0．029）。结论IORT可有效抑制肿瘤的生长、延长患者的生存；止痛效果明显，改善生活质量；毒副作用小、对术后恢复无显著影响、安全可靠；简便、易于掌握。
Objective To assess the value of intraoperative radiotherapy （IORT） in the combined treatment of locally advanced pancreatic cancer. Methods All patients with locally advanced pancreatic cancer at our hospital from January 2007 to December 2009, judged as unresectahle and confirmed by histology or cytology, were recruited into this prospective study. They were randomly assigned into the IORT group （n = 31 ） and control group （n = 34）. The IORT group received IORT plus internal drainage or laparotomy. The control group had internal drainage or laparotomy only. The evaluation of adverse results of two groups included： intraoperative and postoperative adverse events, recent post-operative side effects, analgesic effect, the level of tumor marker such as CA19-9 and the long-term survival. Results There was no difference in operation duration, intraoperative hemorrhage and postoperative recovery. Significant differences were found in hematotoxicology, analgesic effect, tumor marker decreasing and long-term survival. Conclusion IORT is a safe, reliable and easy-to-master technique without any obvious side effect. Its analgesic effect is better than the control group. Also IORT can retard the tumor growth and improve the patient survival.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第4期243-246,共4页
National Medical Journal of China
关键词
胰腺肿瘤
术中放疗
Pancreatic cancer
Intraoperative radiotherapy
