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首页> 外文期刊>Radiation oncology >Stereotactic body radiation therapy with concurrent full-dose gemcitabine for locally advanced pancreatic cancer: a pilot trial demonstrating safety
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Stereotactic body radiation therapy with concurrent full-dose gemcitabine for locally advanced pancreatic cancer: a pilot trial demonstrating safety

机译:立体定向放射疗法联合全剂量吉西他滨治疗局部晚期胰腺癌:显示安全性的先导试验

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Background Concurrent chemoradiation is a standard option for locally advanced pancreatic cancer (LAPC). Concurrent conventional radiation with full-dose gemcitabine has significant toxicity. Stereotactic body radiation therapy (SBRT) may provide the opportunity to administer radiation in a shorter time frame with similar efficacy and reduced toxicity. This Pilot study assessed the safety of concurrent full-dose gemcitabine with SBRT for LAPC. Methods Patients received gemcitabine, 1000 mg/m2 for 6 cycles. During week 4 of cycle 1, patients received SBRT (25 Gy delivered in five consecutive daily fractions of 5 Gy prescribed to the 75-83% isodose line). Acute and late toxicities were assessed using NIH CTCAE v3. Tumor response was assessed by RECIST. Patients underwent an esophagogastroduodenoscopy at baseline, 2, and 6 months to assess the duodenal mucosa. Quality of life (QoL) data was collected before and after treatment using the QLQ-C30 and QLQ-PAN26 questionnaires. Results Between September 2009 and February 2011, 11 patients enrolled with one withdrawal during radiation therapy. Patients had grade 1 to 2 gastrointestinal toxicity from the start of SBRT to 2 weeks after treatment. There were no grade 3 or greater radiation-related toxicities or delays for cycle 2 of gemcitabine. On endoscopy, there were no grade 2 or higher mucosal toxicities. Two patients had a partial response. The median progression free and overall survival were 6.8 and 12.2 months, respectively. Global QoL did not change between baseline and immediately after radiation treatment. Conclusions SBRT with concurrent full dose gemcitabine is safe when administered to patients with LAPC. There is no delay in administration of radiation or chemotherapy, and radiation is completed with minimal toxicity.
机译:背景技术同步放化疗是局部晚期胰腺癌(LAPC)的标准选择。与常规剂量的吉西他滨同时放疗具有明显的毒性。立体定向放射疗法(SBRT)可能会提供在更短的时间内进行放射治疗的机会,并且具有相似的功效和降低的毒性。这项先导研究评估了SBRT并发全剂量吉西他滨对LAPC的安全性。方法患者接受1000 mg / m 2 的吉西他滨6个疗程。在第1周期的第4周,患者接受了SBRT(25 Gy连续5天连续5天,按75-83%的等剂量线处方服用5 Gy)。使用NIH CTCAE v3评估了急性和晚期毒性。 RECIST评估肿瘤反应。患者在基线,第2和第6个月接受食管胃十二指肠镜检查以评估十二指肠粘膜。使用QLQ-C30和QLQ-PAN26问卷收集治疗前后的生活质量(QoL)数据。结果2009年9月至2011年2月,有11例患者在放射治疗期间退出了研究。从SBRT开始至治疗后2周,患者的胃肠道毒性为1至2级。吉西他滨第2周期没有3级或更高的与辐射有关的毒性或延迟。内窥镜检查未见2级或更高的粘膜毒性。两名患者有部分反应。无进展生存期和总生存期中位数分别为6.8和12.2个月。在基线和放射治疗后之间,总体QoL不变。结论SBRT并发全剂量吉西他滨治疗LAPC患者是安全的。放疗或化疗的给药没有延迟,并且放疗以最小的毒性完成。

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