复方红豆杉联合体部伽玛刀治疗局部晚期胰腺癌临床研究

摘要

Objective:To evaluate the clinical toxicity and efficacy of Fufanghongdoushan capsule combined with γ-ray Body Ster-eotactic Radiation Therapy in treatment of locally advanced pancreatic cancer .Methods: A total of 45 patients with locally ad-vanced pancreatic cancer were randomized into two groups .The combination group received γ-ray Stereotactic Body Radiation Therapy which was given isodose curve of 50%~60%, tumor encircling dose of 3.0~4.5 Gy per fraction, 10~11 fractions. Combined with Fufanghongdoushan capsule 0.6 g,three times a day for consecutive 21 days for six courses .And the control group was with γ-ray Stereotactic Body Radiation Therapy only .Toxicities and effects were evaluated according to the criteria of WHO and RTOG.Results:The CR in combination group and control group were 28.6%and 18.5%respectively(P>0.05).Response rate of combination group was 82.1%and 74.1%in control group ( P>0.05 ) .Two groups of the median progression-free surial ( PFS) were 10 months and 6 months respectively;The rate of gastrointestinal tract side reaction in combination group and control group were 82.6%and 68.2%,myelosuppression in combination group and control group were 78.3%and 63.6%,respectively . Conclusion:Fufanghongdoushan capsule combined with body gamma system treatment can improve local control rate and effective rate for inoperable patients with local advanced pancreatic carcinoma , and adverse reaction is well tolerated .%目的：探讨复方红豆杉胶囊（ Fufanghongdoushan capsule ）联合体部伽玛刀（γ-ray Stereotactic Body Radiation Therapy ，γ-SBRT）对局部晚期胰腺癌的治疗效果及安全性。方法：2013年8月至2014年9月海军总医院肿瘤诊疗中心收治的48例局部晚期胰腺癌患者，随机分为2组。研究组25例，采用体部伽玛刀治疗，PTV覆盖95％以上临床靶体积（ Clinical Tar-get Volume，CTV），等剂量曲线为50％～60％，单次周边剂量3.0～4.5 Gy，治疗10～11次，同时给予复方红豆杉胶囊0.6 g，3次／d，21 d为1个周期，治疗后继续口服5个周期，共6个周期。对照组23例，单纯行体部伽玛刀治疗。评价治疗效果及不良反应。结果：2组完全缓解率分别为28.6％和18.5％；研究组有效率为91.3％，对照组有效率为63.6％。2组中位无进展生存期（ PFS）分别为10个月和6个月。2组不良反应相似，胃肠道反应发生率分别为82.6％和68.2％，骨髓抑制发生率分别为78.3％和63.6％。结论：复方红豆杉胶囊配合体部伽玛刀治疗局部晚期胰腺癌可提高局部控制率和有效率，且不良反应的耐受性良好。