全身γ刀治疗胰腺癌75例临床结果分析  

An Analysis of Clinical Outcome of Whole Body Gamma System Therapy in 75 Cases with Pancreatic Carcinoma

作　　者：夏廷毅[1] 于勇[1] 孙庆选[1] 李宏奇[1] 崔纪青[1] 常冬姝[1] 

机构地区：[1]解放军空军总医院,北京100036

出　　处：《中国肿瘤》2006年第8期518-521,共4页China Cancer

摘　　要：[目的]观察全身γ刀治疗胰腺癌的疗效和放射反应。[方法]75例胰腺癌采用全身γ刀治疗,治疗时采用仰卧位,体架和真空负压袋体位固定,CT扫描和三维计划,PTV在GTV外扩1cm,50%剂量线为处方剂量线,胰头癌3Gy/次～4Gy/次,胰体尾癌4Gy/次～5Gy/次,5次/周,肿瘤边缘总剂量40Gy～51Gy,肿瘤中心区域80Gy～102Gy。[结果]原发灶的完全缓解率(CR)21.3%,部分缓解率(PR)48.0%,总有效率(CR+PR)69.3%。Ⅰ、Ⅱ期1、2年生存率分别为62.50%和62.50%,Ⅲ、Ⅳ期1、2年总生存率分别为31.63%和7.91%;Ⅰ、Ⅱ期和Ⅲ、Ⅳ期的2年生存率比较差异有显著性(P=0.0026)。治疗期间胃肠反应Ⅰ～Ⅱ级为57.3%,Ⅲ级5%,经对症处理病人均能按计划完成治疗。[结论]全身γ刀治疗胰腺癌,对不能手术的局部晚期患者可提高局控率和生存率。[Purpose]To observe the effects and radiation toxicity in patients with pancreatic carcinoma by whole body gamma system treatment. [Methods]Seventy-five cases with pancreatic carcinoma were treated with whole body gamma system. For the whole body gamma system treatment, a supine position, as a stereo-tactic body frame for exact tumor localization, reproducible fixation, CT simulation and 3-D treatment plan had been developed. The margin of PTV was more than 1cm in GTV, 50% dose line was prescription dose curve and covered more than 95% area of PTV. For patients with head pancreatic tumor, they were irradiated 3～4Gy/fraction at 50% dose line. For patients with body and tail pancreatic tumor, they were irradiated 4～5Gy/fraction at 50% dose line, 5 days a week. A total dose of 40～51Gy at tumor margin and 80～102Gy at tumor central area were delivered. [Results]The complete response rate （CR） and the partial response rate （PR） for the primary tumor were 21.3% and 48.0% respectively, and the overall response rate （CR＋PR） was 69.3%. The 1-, 2-year overall survival rates were 62.50% and 62.50% respectively, in stage Ⅰ, Ⅱ patients. The 1-, 2-year overall survival rates were 31.63% and 7.91% respectively, in stage Ⅲ, Ⅳ patients. Two-year overall survival rates were significantly different between stage Ⅰ, Ⅱ cases and stage Ⅲ, Ⅳ cases （P = 0.0026）. Acute gastrointestinal toxicity grade of Ⅰ, Ⅱ was observed in 57.3% cases and grade Ⅲ in 5% cases. The whole process was tolerable for all patients after allopathy. [Conclusion]Whole body gamma system treatment for pancreatic carcinoma can improve local control rate and survival rate for inoperable patients with local advanced pancreatic carcinoma.

关 键 词：全身Γ刀 胰腺肿瘤 立体定向放射疗法 

分 类 号：R735.9[医药卫生—肿瘤]