伽玛刀联合复方苦参注射液治疗局部晚期胰腺癌疗效观察

摘要

Objective To investigate clinical effects of Gamma Knife treatment combined with Kunshen injections on locally advanced pancreatic cancer. Methods 62 patients with advanced pancreatic cancer were treated with the OUR - QGC gamma ray,which was combined with matrine injections to treat 31 of them. Gamma Knife treatment used the 50％ -65％ dose isodose curve, coyering more than 95％ of the target area, with a single peripheral dose of 3 - 4 Gy for tumor≤5 cm, 2.5 - 3.5 Gy for the tumor ＞ 5 cm. The total dose was 35 -45 Gy, with 8 - 12 times of treatments and once a day. For the joint treatment group ( Gamma Knife plus Kunshen injections), radiosurgery matrine injection was applied to each patient one week before Gamma Knife treatment, with 30 ml/d for three weeks. Results The clinical benefit response rate for the Gamma knife treatment group was 79.5％, compared to 62.8％for control group. The difference between the two groups was statistically significant ( P ＜ 0.05 ). The term efficacy for the treatment group was 80.6％, compared to 51.6％ for the control group, being significantly different (P ＜0.05). Adverse reactions in terms of hematological toxicity showed that the incidence of leucopenia was 30.5％ and 40.2％ for treatment group and control group respectively, being statistically significant (P ＜ 0. 05 ). No - hematological toxicity comparison showed that gastrointestinal tract reaction was 39.3％ and 41.6 for the treatment and control groups, which was not statistically different ( P ＞ 0. 05). Conclusions Effective treatment with the Gamma Knife was observed on locally advanced pancreatic cancer. Usc of Kushen injections can attenuate pain reactions,enhance the effect of treatment, and serve as an adjuvant drug for clinical radiotherapy.%目的 研究伽玛刀联合复方苦参注射液治疗局部晚期胰腺癌的近期临床疗效.方法 采用OUR-QGD型立体定向伽玛射线体部治疗系统治疗62例晚期胰腺癌患者,其中联合复方苦参注射液治疗31例.伽玛刀治疗一般剂量为50%～65%等剂量曲线包绕靶区的95%以上,肿瘤≤5 cm的单次周边剂量为3～4 Gy,肿瘤>5 cm的单次周边剂量为2.5～3.5 Gy;治疗总剂量为35～45 Gy;治疗8～12次,患者通常每日1次.联合复方苦参组从伽玛刀治疗前1周给予输注复方苦参注射液,30 ml/d,共3周.结果 伽玛刀治疗后治疗组临床受益反应率为79.5%(25/31),对照组为62.8%(20/31),两组比较差异具有统计学意义(P<0.05);治疗组近期疗效为 80.6%(25/31),对照组为51.6%(16/31),两组比较差异具有统计学意义(P<0.05);不良反应中血液学比较,治疗组白细胞下降发生率为30.5%(9/31),对照组为40.2(13/31),两组比较差异具有统计学意义(P<0.05),非血液学不良反应比较,治疗组胃肠道反应发生率为39.3%(12/31),对照组为41.6(13/31),两组比较差异无统计学意义(P＞0.05).结论 伽玛刀治疗局部晚期胰腺癌效果确切,近期疗效好,联合复方苦参注射液后可有减轻不良反应增强疗效作用,可以作为临床放疗的辅助药物.