局部晚期胰腺癌三维适形放疗联合健择化疗疗效分析

摘要

Objective To evaluate the acute side effects and efficacy of three dimensional-cnnfor malradiotherapy combined with gemcitabine chemotherapy for locally advanced pancreatic cancers Methods 27 patients with locally advanced pancreatic cancers were treated with Three dimensional-eonformal radiotherapy combined with gcmcitabine chemotherapy. Results The complete response rate (CR), partly response rate (PR), overall respons rate (CR + PR) were22. 2% (6/27) ,66.7 % (18/27) and 81.5 % ( 22/27 ) respectively.Clinical benefit response(CBR) 81.5% (22/27) ,the 1-year and 2-year survival rate were 74. 1% (20/27) and 48.1% (13/27) respectively. Acute leukocytopenia occurred, the alimentary canal response rate were100. 1%(27/27) and 96. 3 % (26/27) respectively. Conclusion Three dimensional-eonformal radiotherapy with gem-eitabine chemotherapy is well tolerated and improved response rate in moat patients with locally advanced pan-creatic cancers.%目的 观察三维适形放射治疗(3 d-CRT)联合健择化疗治疗局部晚期胰腺癌的疗效及耐受性.方法 27例局部晚期胰腺癌进入三维适形放射治疗联合健择化疗治疗组,化疗方案健择1 000mg/m<2>第1、8、15天,每4周为1周期,共治疗2周期.同步进行3 d-CRT,计划照射剂量6 mV/15 mYV-X线:4～5 Gy/次/d,每周3次,DT 50～60 Gy/10～12次.结果 27例患者全部完成治疗计划,胰腺癌原发灶完全缓解(CR)为22.2%(6/27),部分缓解(PR)66.7%(18/27),总有效率为(CR+PR)88.9%(24/27),无变化和进展(NC+PD)占11.1%(3/27).临床获益率为81.5%(22/27).中位随访期为32(24～37)个月.1年生存率为74.1%(20/27),2年生存率为48.1%(13/27),中位生存期26个月.白细胞下降发生率及胃肠道反应发生率分别为100.0%(27/27)、96.3%(26/27).结论 三维适形放射治疗联合健择化疗治疗局部晚期胰腺癌疗效较好,可以明显提高患者的生活质量和生存期.不良反应能为多数患者耐受,是治疗局部晚期胰腺癌的较好的方法.