三维适形放射治疗胰腺癌临床探讨  

Treatment of pancreatic cancer by 3-dimensional conformal radiation in combination with external irradiation

作　　者：周桂霞[1] 崔书祥[1] 马林[1] 徐寿平[1] 

机构地区：[1]解放军总医院放疗科,北京市100853

出　　处：《中华肝胆外科杂志》2005年第10期668-670,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨三维适形放射治疗(3 dimensional conformal radiotherapy, 3DCRT)胰腺癌临床疗效.资料与方法 55例胰腺癌病人(男42例、女13例);39例病人先外照射DT 20～40 Gy后、再行3DCRT,9例行单纯3DCRT,7例外照射与3DCRT同时进行.单次照射剂量3～7 Gy、平均4.5 Gy,隔日照射1次、共3～14次;4～6个弧形或非共面适形固定野照射,照射总剂量21～48 Gy.结果所有病人疼痛快速缓解率为83.64%,有效率为96.36%.放疗后6～12个月复查CT,CR 4例,PR 30例,NR 13例,PD 8例,总有效率为61.82%.Kaplan-Meier生存率分析,1、2、3年生存率分别为81.26%、24.38%、14.17%;存活时间最短4个月、最长49个月,中位生存期21个月;死亡36例,其中死于肝转移9例、多发转移12例、肿瘤局部进展11例、其他疾病4例.结论 3DCRT胰腺癌具有缓解疼痛快、能提高肿瘤局部照射剂量和增加肿瘤局部控制率,在缩短疗程的同时、不增加近期放疗反应和远期并发症.Objective To investigate the therapeutic effects of 3-dimensional conformal radiation （3-DCR） in combination with external irradiation （EI） on pancreatic cancer. Methods A total of 55 patients with pancreatic cancer were treated with 3DCR on the basis of EI at the dose of 20-40 Gy. The single dose for 3DCR was 3-7 Gy. The radiation was performed by using 4-6 non-coplanar stationary beams or arc radiation once every 2 d in 3-14 fractions and at a total dose of 21-48 Gy. Results The immediate pain-alleviating rate and effective rate were 78.2% and 92.7%, respectively. CT scanning performed 6-12 months after the treatment in the patients showed that the tumor size was reduced in 4 patients for CT, 30 for PR, 13 for NR and 8 for PD. The effective rate of CR＋PR was 61.82%. Kaplan-Merie analysis indicated that the 1-, 2- and 3-year survival rates were 81.26%, 24.38% and 14.17%, respectively, and the median survival time was 21 months. The shortest survival time was 4 months and the longest one 49 months. Thirty-six out of the 55 patients died. Of the 36 patients, 9 died of liver metastasis, 11 multiple metastasis, 12 local progression and 4 other diseases. Conclusions The 3DCR is of precise localization. It can enhance the tumor local control rate, shorten the treatment duration but not raise the recent radiation response and complication.

关 键 词：胰腺肿瘤 3DCRT 三维适形放射治疗 胰腺癌病人 临床探讨 局部控制率 照射剂量 总有效率 缓解疼痛 固定野照射 

分 类 号：R735.9[医药卫生—肿瘤]