摘要
目的 观察替吉奥联合体部伽玛刀对局部晚期胰腺癌患者的治疗效果及安全性.方法 45例局部晚期胰腺癌患者被随机分为两组,联合组23例患者采用体部伽玛刀治疗,计划靶体积（PTV）覆盖95％以上临床靶体积（CTV）,等剂量曲线为50％～60％.肿瘤直径≤5 cm的单次周边剂量3.6～4.5 Gy,肿瘤直径＞5 cm的单次周边剂量3.0～4.0 Gy,治疗9～ 12次,同时口服替吉奥40 mg/m2,2次/d,连续口服21 d,28 d为1个周期,口服4个周期.对照组22例患者单纯接受体部伽玛刀治疗.评价治疗效果及不良反应.结果 两组完全缓解率分别30.4％（7/23）和13.6％（3/22）,有效率分别为91.3％（21/23）和63.6％（14/22）,差异具有统计学意义（x2=4.980,P=0.026）.两组胃肠道反应发生率分别为82.6％和68.2％（x2=1.267,P=0.260）;骨髓抑制发生率分别为78.3％和63.6％（x2=1.171,P=0.279）,联合组Ⅲ～Ⅳ级骨髓抑制的发生率高于对照组（x2=4.874,P=0.027）.两组中位无进展生存期分别为8个月和6个月（x2=1.357,P＞0.05）;中位总生存期分别为17个月和14个月（x2=1.017,P＞ 0.05）;1年生存率分别为60.9％和54.5％（x2=0.184,P＞ 0.05）.结论 口服替吉奥配合体部伽玛刀治疗胰腺癌可提高患者局部控制率和有效率,且不良反应的耐受性良好,可作为局部晚期胰腺癌同步放化疗安全、有效的选择.
Objective To evaluate the clinical toxicity and efficacy of S-1 combined with γ-ray body stereotactic radiation therapy in treatment of locally advanced pancreatic cancer.Methods Forty-five patients with locally advanced pancreatic cancer were randomly divided into two groups.The combination group received γ-ray stereotactic body radiation therapy which was given isodose curve of 50 ％-60 ％,tumor encircling dose of 3.0-4.5 Gy per fraction depended on dimension of tumors,9-12 fractions.Combined with S-1 40 mg/m2,2 times/d,for consecutive twenty-one days for four courses.The control group was given γ-ray stereotactic body radiation therapy only.Toxicities and effects were evaluated according to the criteria of WHO and RTOG.Results The CR rates in combination group and control group were 30.4 ％ （7/23） and 13.6 ％ （3/22）,the response rates were 91.3 ％ （21/23） and 63.6 ％ （14/22） （x2 =4.980,P =0.026）.The rates of gastrointestinal tract side reaction in combination group and control group were 82.6 ％ and 68.2 ％ （x2 =1.267,P =0.260）,myelosuppression in combination group and control group were 78.3 ％ and 63.6 ％ （x2 =1.171,P =0.279）.The rate of Ⅲ-Ⅳ grade myelosuppression in combination group were higher than that in control group （x2 =4.874,P =0.027）.The median progression-free survival （PFS） rates of two groups were 8 months and 6 months respectively （x2 =1.357,P ＞ 0.05）,the median survival period were 17 months and 14 months （x2 =1.017,P ＞ 0.05）,1 year survival rates were 60.9 ％ and 54.5 ％ respectively （x2 =0.184,P ＞ 0.05）.Conclusions S-1 combined with body gamma system treatment can improve local control rate and effective rate for inoperable patients with local advanced pancreatic carcinoma,and the adverse reactions are well tolerated.This method can be used as locally advanced pancreatic cancer chemoradiation safe and effective choice.
出处
《肿瘤研究与临床》
CAS
2014年第9期617-619,623,共4页
Cancer Research and Clinic
关键词
胰腺肿瘤
替吉奥
体部伽玛刀
治疗
Pancreatic neoplasms
S-1
γ-ray stereotactic body radiation therapy
Therapy
