3D-CRT联合GF方案同期治疗局部晚期胰腺癌  

Treatment of locally advanced pancreatic cancer with three dimensional conformal radiotherapy combined with gemcitabine and 5-FU chemotherapy

作　　者：季斌[1] 仇晓军[1] 王燕[1] 周学军[2] 赵洪瑜[1] 汤乐民[1] 施健[1] 陈晓珏[1] 周兴芹[1] 蔡晶[3] 谢国栋[3] 万志龙[3] 

机构地区：[1]南通大学附属医院放射治疗科,226001 [2]南通大学附属医院影像科,226001 [3]南通大学附属肿瘤医院放射治疗科

出　　处：《江苏医药》2010年第22期2659-2662,共4页Jiangsu Medical Journal

基　　金：南通市科技局基金(S2007042)

摘　　要：目的观察三维适形放射治疗（3D-CRT）联合吉西他滨（GEM）＋氟脲嘧啶（5-FU）方案（GF方案）同期治疗局部晚期胰腺癌的疗效和毒性反应。方法 39例局部晚期胰腺癌患者随机分为同期放化疗组（A组,19例）和序贯放化疗组（B组,20例）。所有患者化疗予以GEM 800 mg/m2,5-FU 500 mg/m2,d1、d8、d15。应用5-FU前常规予以亚叶酸钙（FA）200 mg加入生理盐水250 ml中静脉滴注,28 d为1周期,连续2周期。给予3D-CRT放疗,常规分割,每次2 Gy,每周5次,3~6.5周,总剂量30~64 Gy。结果 39例患者全部完成治疗计划。A、B组有效（CR＋PR）率分别为73.7%、40.0%（P〈0.05）;A、B组中位生存时间分别为12.3个月和9.6个月（P〈0.05）。两组患者的毒副反应相当,均未出现严重的放化疗并发症。结论 3D-CRT加同期GF化疗治疗局部晚期胰腺癌能明显提高患者的生活质量和生存期,不良反应能为大多数患者耐受。Objective To evaluate the efficacy and toxicity of three dimensional conformal radiotherapy（3D-CRT） combined with gemcitabine and 5-fluorouracil（5-FU） in patients with locally advanced pancreatic cancer（LAPC）.Methods Thirty-nine LAPC patients were divided into 2 groups of synchro nized（group A,19 cases） and sequential（group B,20 cases）.The patients were given chemotherapy with gemcitabine 800mg/m2 and 5-FU 500mg/m2 at d1,d8 and d15.Before 5-FU,folinic acid（FA） 200mg added into NS 250ml was intravenously injected with 28d per cycle for 2 cycles continuously.3D-CRT was given by 2 Gy every time and five times per week.In 3-6.5 weeks,a total dosage of 30-64 Gy was given.Results All patients finished the regimen with the effective rate of 73.7% in group A and that of 40.0% in group B（P0.05）.The median survive time of groups of A and B were 12.3 months and 9.6 months,respectively（P0.05）.The side effects were similar in two groups and there was no severe in all patients.Conclusion 3D-CRT combined with gemcitabine and 5-FU concurrently can effectively improve the quality of life and survival cycle in LAPC patients with well tolerated side effects.

关 键 词：胰腺癌 三维适形放射治疗 吉西他滨 氟脲嘧啶 

分 类 号：R735[医药卫生—肿瘤]