适形放疗同步吉西他滨治疗晚期胰腺癌疗效分析  

Feasibility and safety of limited-field three-dimensional conformal radiotherapy with concurrent weekly medium-dose gemcitabine in patients with unresectable pancreatic cancer

作　　者：穆晓峰[1] 曹京旭[1] 王迎选[1] 史铭[1] 宁健[1] 吴芳[2] 宋薇[1] 李韧[1] 付淑云[1] 

机构地区：[1]武警总医院肿瘤中心,北京100039 [2]武警总医院药房,北京100039

出　　处：《武警医学》2010年第9期766-769,772,共5页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨采用适形放疗同步吉西他滨治疗不可切除胰腺癌的疗效及安全性。方法 22例不可手术切除的胰腺癌患者接受同步放化疗,均采用三维适形放疗,靶区DT:36～58Gy/9～25F;同步化疗采用单药吉西他滨每周600～750mg/m^2,静滴,1次/周,共4～7周;治疗期间观察有效率、中位生存期、1年生存率及不良反应。结果 CR3例(13.6%),PR4例(18.2%),SD10例(45.5%);有效率(CR+PR)31.8%,疾病控制率77.3%;1年生存率为31.8%;中位生存期为8.1个月。治疗过程中有7例出现Ⅲ-Ⅳ毒性反应,其中5例表现为血小板下降,对症治疗可恢复,无治疗相关死亡事件发生。结论三维适形放疗同步单药吉西他滨对不可切除胰腺癌的治疗安全、有效。Objective To study the feasibility and safety of concurrent use of medium - dose gemcitabine （GEM） and limited -field three- dimensional eonformal radiotherapy（LTDR） for unresectable pancreatic cancer. Methods Twenty -two patients with unresectable pancreatic cancer treated with GEM （ GEM 600 - 750 mg/m2/weekly for 7weeks ） concurrently with limited - field three - dimensional eonformal radiotherapy （ median dose,52 Gy; range, 36 - 58Gy） were enrolled. The response, survival, toxicity, and prognostic factors were evaluated. Results With a median follow - up of 10 months, the 1 - and 2 - year survival rates were 31.8% and 9% , respectively. The median overall survival （OS） and median time to progression （TTP） were 8. 1 and 4.0 months, respectively. OS was associated with level of tumor marker,radiation dose and maintenance chemotherapy（ P 〈 0.05 ）. The response rate was 31.8% （3 complete responses and 4 partial responses）. The major grade 3 -4 toxicities were neutropenia （2/7） , anorexia （4/7） and thromboeytopenia（5/7）. All the adverse events subsided without treatment-related death. Conclusions GEM - LTDR is effective and tolerable for patients with unreseetable pancreatic cancer.

关 键 词：三维适形放疗 吉西他滨 胰腺癌 

分 类 号：R735.9[医药卫生—肿瘤] R453.9[医药卫生—临床医学]