中华放射医学与防护杂志

蔡勇,苏星,孙淑芬,等.放化同步治疗局部进展期胰腺癌[J].中华放射医学与防护杂志,2006,26(3):253-255.CAI Yong,SU Xing,SUN Shu-fen,et al.Concomitant chemotherapy with radiotherapy in locally advanced pancreatic cancer[J].Chin J Radiol Med Prot,2006,26(3):253-255

放化同步治疗局部进展期胰腺癌

Concomitant chemotherapy with radiotherapy in locally advanced pancreatic cancer

投稿时间：2005-06-28

DOI：

中文关键词: 局部进展期胰腺癌放射治疗药物疗法综合治疗

英文关键词:Locally advanced pancreatic cancer Radiotherapy Drug therapy Combined modality therapy

基金项目:

作者	单位	E-mail
蔡勇	100036, 北京大学临床肿瘤学院北京肿瘤医院放疗科	caiyong109@sohu.com
苏星	100036, 北京大学临床肿瘤学院北京肿瘤医院放疗科
孙淑芬	山东威海市立医院肿瘤科
刘长青	100036, 北京大学临床肿瘤学院北京肿瘤医院放疗科
张珊文	100036, 北京大学临床肿瘤学院北京肿瘤医院放疗科
徐博	100036, 北京大学临床肿瘤学院北京肿瘤医院放疗科

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中文摘要:

目的评价放化综合治疗局部进展期胰腺癌(LAPC)的疗效。方法 36例局部进展期胰腺癌采用放化同步治疗,化疗的方案分为:①5-Fu500mg,2次/周(13例);②5-Fu500mg+DDP30mg,1次/周(16例);③健择(GEM)600mg,1次/周(7例);所有病人均完成3～7周的化疗。20例采用常规放射治疗,中位照射剂量50Gy(21～60Gy),16例采用三维适形放疗(3D-CRT)多野(3～5野)照射或补量,中位照射剂量60Gy(50～70Gy)。结果临床受益反应(CBR):15例,占41.6%;全部患者近期疗效:CR0,PR4例占11.1%,SD24例占66.6%,PD8例占22.2%,其中3D-CRT的有效率(16.6%)高于常规放疗(5%,P=0.017);全部病人生存率为:1年33.1%、2年11.2%。中位生存时间9.6个月(3～26个月);1年生存率3D-CRT和常规放疗分别是41.2%和27.7%(P=0.41);1～2度骨髓抑制41.6%(15例),3度骨髓抑制8.3%(3例),急性放射性胃肠炎1～2度52.8%(19例),3度2.8%(1例)。结论对局部进展期胰腺癌采用放化综合治疗可取得一定的疗效,且毒副作用可耐受。

英文摘要:

Objective To evaluate the effect of concurrent chemotherapy with radiotherapy for locally advanced pancreatic cancer (LAPC). Methods Thirty-six cases of LAPC were treated with concurrent chemoradiotherapy from June 1998 to December 2004. The regimens of chemotherapy were as follows: A. 13 patients, 5-Fu 500mg, twice a week; B. 16 patients, 5_Fu 500 mg + DDP 300 mg, once a week; C. 7 patients, gemcitabine (GEM) 600 mg, once a week. All the patients were administered such regimens for 3₇ weeks. Twenty patients were treated with conventional radiation therapy (CRT), the median dose was 50 Gy (ranged from 21 to 60 Gy). Sixteen patients were treated with three_dimensional conformal radiation therapy (3D-CRT), the median dose was 60Gy (ranged from 50 to 70 Gy). Results Clinical benefit response (CBR) was 41.6% (15/36 patients). The overall response rates (CR+PR), SD rates, PD rates were 11.1% (4 patients), 66.6% (24 patients), 22.2% (8 patients), respectively. The response rate (CR+PR) of 3D-CRT was 16.6%, which was significantly higher than that in the CRT (5%) (P=0.017). The overall 1- and 2-year survival rates were 33.1%, 11.2%, respectively. The 1-year survival rates were 41.2% and 27.7% in 3D-CRT group (18 patients) and CRT group (20 patients), respectively. The difference between the two groups was statistically significant (P=0.41). 41.6% of the patients showed grade 1-2 hematologic toxicity, 8.3% for the grade 3 hematologic toxicity. Grade 1-2 gastrointestinal toxicity was observed for 52.8% patients, Grade 3 was for 2.8% patients. Conclusion The combined modality treatment is an effective method for LAPC, and the side effects are acceptable.

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