中国肿瘤临床与康复

目的观察三维适形放疗同步替吉奥治疗局部晚期胰腺癌的近期疗效及毒副反应。方法 63例患者随机分为两组:联合组32例,采用三维适形放疗同步替吉奥治疗;三维适形放疗组31例;三维适形放疗分割剂量为2 Gy/次,5次/周,总剂量50～60 Gy。联合组自放疗开始起口服维康达[80 mg/(m2.d)],每日2次,第1～14天,每周期21 d,至少2个周期。结果联合组4例完全缓解(CR),9例部分缓解(PR),有效率43.75%;放疗组1例CR,5例PR,有效率19.35%,两组疗效比较差异有统计学意义(P=0.032)。联合组和单纯放疗组1年、2年生产率分别为50%、21.88%和25.81%、12.9%,中位生存期为13月和8月,两组生存时间比较差异有统计学意义(P=0.024)。两组毒副反应比较在恶心、呕吐,白细胞减少及贫血方面差异有统计学意义(均P<0.05),均未出现Ⅳ级副反应。所有副反应经过临床处理可以得到控制。结论替吉奥联合三维适形放疗治疗局部晚期胰腺癌是一种安全有效的治疗方法。

Objective To evaluate the efficacy and toxicity of three-dimensional conformal radiation therapy(3DCRT) combined with T S-1 for treatment locally advanced pancreatic cancer.Methods 63 patients randomly divided into two groups.Combine group 32 cases(3DCRT and TS-1),3DCRT group 31 cases.The total dose of 3DCRT was 50-60 Gy(2 Gy/f,5f/w).Combine group received two cycles of TS-1 treatment at dosage of 80 mg/(m2·day).21 days per cycle.administration for 2 cucles.Results In the patients of combine group 4 cases complete remission,9 cases partial response,the efficient response were 43.75%,In the patients of 3DCRT group,they were 1,5,19.35% respectivly,There were significant difference between combine group and 3D-CRT group(P= 0.032).The 1,2 years survival rates in combine group and 3-DCRT were 50%,21.88% and 25.81%、12.9% respectively.The median survival was 13and 8 months respectively(P=0.024).Two groups of survival time were difference.Two groups of adverse reaction comparison in nausea,vomiting,leucopenia and anemia had significant difference(P= 0.002,0.021,0.001),all of these cases did not appeared level Ⅳ side effects and all these side effects can be controlled.Conclusion Three-dimensional conformal radiation therapy(3DCRT)combined with TS-1 is effective and safe for patients with advanced pancreatic cancer.