【摘要】 目的探讨容积旋转调强放射治疗(VMAT)治疗局部晚期胰腺癌的临床疗效及安全性。方法对45例局部晚期胰腺癌患者采用容积旋转调强放射治疗(VMAT)进行放射治疗。放疗处方剂量PTV 50.4 Gy/1.8 Gy/28F,PGTV 59.4 Gy/1.8 Gy/33F,5次/周。观察近期疗效、疼痛缓解情况,CA199水平,放疗毒性反应及生存期。结果放疗后1个月行CT复查,总有效率(CR+PR)为82.2%(37/45)。腹痛缓解率79.5%(31/39),黄疸消退率77%(10/13),血清CA199水平进行疗效评价总有效率为75.6%(34/45)。1年生存率58.6%,2年生存率13%。放疗所致不良反应主要为Ⅰ～Ⅱ级胃肠道反应和骨髓抑制。结论容积旋转调强放射治疗(VMAT)局部晚期胰腺癌姑息止痛效果好,退黄作用快,毒副反应轻,可提高患者生存质量,延长生存。更多还原

【Abstract】 Objective To investigate the therapeutic effects and safety of volume rotation intensity-modulated radiotherapy(VMAT) in treatment of local advanced pancreatic cancer.Methods A total of 45 patients with local advanced pancreatic cancer who were treated by VMAT in our hospital were enrolled in the study.The prescription dose of radiotherapy was PTV 50.4 Gy/1.8 Gy/28 F,PGTV 59.4 Gy/1.8 Gy/33 F,five times a week.The short-term curative effects,pain relive status,CA199 levels,the incidence of toxic reaction caused by radiotherapy,and survival durantion of patients were observed.Results At one month after radiotherapy,CT Reexamination showed that the total effective rate(CR+PR) was 82.2%(37/45), and the remission rate of abdominal pain was 80%(31/39),jaundice regression rate was 77%(10/13).According to the serum levels,the total effective rate was 75.6%(34/45).Moreover the 1-year survival rate was 58.6%,and the 2-year survival rate was 13%.The main side effects of radiotherapy were grade Ⅰ～Ⅱ gastrointestinal reactions and myelosuppression.Conclusion VMAT has better palliative and analgesic effects in treatment of local advanced pancreatic cancer,with rapid effect of reducing jaundice and mild side effects,which can improve the life quality and prolong the survival duration of patients.更多还原