【摘要】 目的:回顾性分析三维适形放射疗法(three dimensional-conformal radiotherapy,3DCRT)同步吉西他滨化疗治疗中晚期胰腺癌的疗效和安全性。方法:收集2005年6月-2010年6月接受3DCRT同步吉西他滨化疗的32例Ⅲ～Ⅳ期初治中晚期胰腺癌患者的临床资料。从放疗第1周起同步化疗,吉西他滨500～750mg/m2d1静脉滴注,每周1次,直至放疗结束。6MV X线50.0～50.4Gy,1.8～2.0Gy/次,1次/d,每周5d。结果:32例患者均全部完成放疗计划,8例患者按计划完成放化疗。完全缓解1例(3.1%)、部分缓解8例(25.0%)、疾病稳定15例(46.9%)、疾病进展8例(25.0%),总有效率为28.1%(9/32),疼痛缓解率达75.9%(22/29)。中位生存时间为10.6个月,1年生存率为20.4%,2年生存率为0%。主要不良反应为白细胞减少(62.5%)、血小板减少(59.4%)、恶心和呕吐(81.2%)和肝功能损害(78.1%),未发生4级不良反应。结论:3DCRT同步吉西他滨化疗治疗中晚期胰腺癌显示出较好的疗效,可明显提高患者的生活质量,延长患者的生存期,且不良反应可耐受。更多还原

【Abstract】 Objective: To retrospectively analyze the efficacy and safety of three dimensional-conformal radiotherapy (3DCRT) combined with concurrent gemcitabine chemotherapy in the treatment of patients with middle-advanced pancreatic cancer. Methods: From June 2005 to June 2010, 32 patients newly diagnosed with stage Ⅲ/Ⅳ pancreatic cancer were treated with 3DCRT combined with concurrent gemcitabine. The medical records of these 32 patients were reviewed. All patients received gemcitabine of 500-750 mg/m2 weekly from the first day of 3DCRT, and this chemotherapy continued until the completion of 3DCRT. The total dose of 3DCRT was 50.0-50.4 Gy, 1.8-2.0 Gy daily, 5 times a week. Results: All the 32 patients completed the 3DCRT treatment plan, and 8 patients completed radiochemotherapy by plan. One patient (3.1%) accepted complete response, 8 patients (25.0%) accepted partial response, 15 patients (46.9%) accepted stable disease, 8 patients (25.0%) accepted progressive disease. The response rate was 28.1% (9/32), and the pain control rate was 75.9 % (22/29). The median survival time was 10.6 months. The 1- and 2-year survival rates were 20.4% and 0%, respectively. The major adverse reactions were neutropenia (62.5%), thrombocytopenia (59.4%), nausea and vomiting (81.2%) and liver dysfunction (78.1%). No grade 4 adverse reactions were observed. Conclusion: 3DCRT combined with concurrent gemcitabine exhibits a better treatment outcome in patients with middle-advanced pancreatic cancer. The quality of life is improved, the survival time is prolonged, and the adverse effects are well tolerated.更多还原