41例局部晚期不可手术胰腺癌三维适形或调强放疗的临床分析  

Outcome of three-dimensional conformal radiation therapy and intensity-modulated radiation therapy for inoperable locally advanced pancreatic cancer

作　　者：卢宁宁[1] 金晶[1] 李晔雄[1] 余子豪[1] 刘新帆[1] 王维虎[1] 王淑莲[1] 宋永文[1] 刘跃平[1] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤医院肿瘤研究所放疗科,北京100021

出　　处：《中华放射肿瘤学杂志》2009年第2期120-123,共4页Chinese Journal of Radiation Oncology

基　　金：卫生部临床学科重点项目（07090010）

摘　　要：目的分析局部晚期胰腺癌以放疗为主的治疗结果。方法搜集2007年12月前近8年初治局部晚期胰腺癌临床资料，期1例，均为2002AJCC分期Ⅲ期。采用三维适形或调强放疗，单纯放疗11例，同步放化疗30例。结果全组中位生存时间和1年总生存率分别为9．2个月和23％。疗前KPS评分≥80、无区域淋巴结转移和放疗后达完全缓解或部分缓解者提示可获得更好生存期，其中位生存时间分别为11．1个月：5．8个月（χ^2=7．50，P=0．006）、10．8个月：6．5个月（χ^2=5．67，P=0．017）和19．5个月：9．1个月（χ^2=7．28，P=0．007）。同步化疗的加入较单纯放疗有提高生存的趋势（χ^2=3．25，P=0．072）。放疗末总临床获益者18例，主要为腹痛缓解17例（41％）。无4级血液学毒性及3级非血液学毒性发生。结论三维适形或调强放疗局部晚期胰腺癌副反应低，可提高临床获益。疗前KPS较高、无区域淋巴结转移和疗后达完全缓解或部分缓解者可望获得较好疗效，加同步化疗有提高生存率趋势。Objective To evaluate the outcome of radiotherapy for locally advanced pancreatic cancer. Methods From January 2000 to December 2007,41 patients with inoperable locally advanced （stage Ⅲ ） pancreatic cancer were treated with three-dimensional conformal radiation therapy （3DCRT） or intensity-modulated radiation therapy （IMRT）. Among these patients, 30 received concurrent radio-chemo-therapy. Results The median survival time（MST） and 1-year overall survival were 9.2 months and 23%. Patients with pretreatment KPS I〉80, no regional lymph nodes metastasis, and CR/PR after radiotherapy had better prognosis. The corresponding MSTs were 11.1 months vs 5.8 months（ χ^2 = 7.50,P = 0.006） , 10.8 months vs 6.5 months（χ^2 =5.67 ,P =0. 017） ,and 19.5 months vs 9.1 months（χ^2 =7.28 ,P =0. 007） ,respectively. Concurrent radio-chemotherapy tended to improve the overall survival （ χ^2 = 3.25, P = 0.072 ）. After radiotherapy, 18 patients had clinical benefit response, mainly being abdominal pain relief. Neither grade 4 hematologic nor grade 3 non-hematologic toxicities were observed. Conclusions For patients with locally advanced pancreatic cancer, both 3DCRT and IMRT are effective in alleviation of disease-related symptoms. Patients with better performance status before treatment, no regional lymph nodes metastasis, and better response to radiotherapy may have better prognosis. Concurrent radio-chemotherapy trend to improve overall survival when compared with radiotherapy alone.

关 键 词：胰腺肿瘤/放射疗法 调强适形 胰腺肿瘤/放化疗法 同步 治疗结果 

分 类 号：R686[医药卫生—骨科学]