超级γ刀治疗胰腺癌46例临床结果分析  

Clinical outcome of super gamma system therapy in 46 cases with pancreatic carcinoma

作　　者：党亚正 扬洁[2] 费晋秀 吴发伟 雷续虎 陆婉玲 

机构地区：[1]解放军323医院肿瘤中心,陕西西安710054 [2]解放军第一医院,甘肃兰州730020

出　　处：《现代肿瘤医学》2008年第2期253-255,共3页Journal of Modern Oncology

摘　　要：目的:观察超级γ刀治疗胰腺癌的疗效和放射反应。方法:46例胰腺癌采用超级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,处方剂量3Gy-5Gy/次,4-5次/周,肿瘤边缘总剂量40Gy-50Gy,肿瘤中心区域80Gy-100Gy。结果:原发灶的完全缓解率(CR)13.0%,部分缓解率(PR)60.1%,总有效率(CR+PR)73.9%。Ⅰ、Ⅱ期1、2年生存率分别为80.0%和50.0%,Ⅲ、Ⅳ期1、2年总生存率分别为44.4%和22.2%;Ⅰ、Ⅱ期和Ⅲ、Ⅳ期的2年生存率比较有显著差异(P<0.05)。治疗期间胃肠反应Ⅰ-Ⅱ级为60.3%,Ⅲ级13.0%,经对症处理病人均能按计划完成治疗。结论:超级γ刀治疗胰腺癌,对不能手术的患者可提高局控率和生存率。Objective：To obserye the effects and radiation toxicity in patients with pancreatic carcinoma by super gamma system treatment. Methods： Forty - six 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 performed. The margin of PTV was more than lcm in GTV, 50% dose line was prescription dose curve and covered more than 95% area of PTV, irradiated 3Gy - 5Gy/fraction at 50% dose line, 4 -5 days a week. A total dose of40Gy -50Gy at tumor margin and 80Gy - 100Gy at tumor central area were delivered. Results： The complete response rate （CR） and the partial response rate （PR） for the primary tumor were 13.0% and 60.1% respectively, and the overall response rate （CR ＋PR） was 73.9%. The 1 -, 2 -year overall survival rates were 80.0% and 50.0% respectively, in stage Ⅰ , Ⅱ patients. The 1 -, 2 - year overall survival rates were 44.4% and 22.2% respectively, in stage Ⅲ, Ⅳ patients. Two - year overall survival rates were different between stage Ⅰ , Ⅱ cases and stage Ⅲ , Ⅳ cases （P 〈 0.05）. Acute gastrointestinal toxicity grade of Ⅰ , Ⅱ was observed in 60.3% cases and grade Ⅲ in 13.0% cases. The whole process was tolerable for all patients after allopathy. Conclusion： Super 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：超级γ刀 胰腺肿瘤 立体定向放射疗法 

分 类 号：R730.3[医药卫生—肿瘤]