体部伽玛刀治疗晚期胰腺癌的临床分析  

Clinical analysis of whole-body stereotactic radiation treatment sytem for patients with advanced pancreatic carcinoma

作　　者：徐周敏[1] 陈焱[1] 裴峰[1] 陈坚[1] 高巍然[1] 瞿琴[1] 孔祥军[1] 

机构地区：[1]武警上海总队医院肿瘤科,上海市201103

出　　处：《现代肿瘤医学》2011年第6期1164-1166,共3页Journal of Modern Oncology

摘　　要：目的:探讨体部伽玛刀治疗晚期胰腺癌的安全性和有效性。方法:采用SGS-Ⅰ型立体定向伽玛射线体部治疗系统(体部伽玛刀)治疗79例晚期胰腺癌患者。伽玛刀治疗采用三维立体定向治疗计划系统给予患者精确定位。在临床靶区(CTV)边缘外放5mm-10mm形成计划靶区(PTV);等剂量线为50%-60%,肿瘤≤5cm的单次周边剂量3.5-4.5Gy,肿瘤>5 cm的单次周边剂量3.0-4.0Gy;治疗总剂量为35-48Gy;治疗次数9-11次,大多数患者为每周5次治疗。观察病人的有效率、生存时间和临床受益率(CBR)。结果:伽玛刀治疗过程中88.9%患者上腹部及腰背部疼痛明显减轻;66.7%患者黄疸指数下降。CBR 69.6%。伽玛刀治疗3个月复查CT,病变部位达到CR 1例,PR 25例;总有效率(CR+PR)32.9%。主要不良反应为:恶心,呕吐,骨髓抑制。结论:伽玛刀是治疗晚期胰腺癌的安全、有效的治疗方法。为临床肿瘤医师提供了一个新的治疗手段。Objective：To evaluate the efficacy and safety of treating advanced pancreatic cancer（PaC） with whole-body stereotactic radiation treatment sytem（gamma knife）.Methods：Total of 79 cases of advanced PaC were treated with gamma knife（type SGS-1）.The margin of PTV was over 0.5cm-1.0cm in GTV,50%-60% dose line was prescribed dose curve and covered over 90%area of PTV.Encircled dose of carcinoma which was less than or equal to 5cm was 3.5-4.5Gy per fraction,of carcinoma which was greater than 5cm was 3.0-4.0Gy per fraction.Majority were treated 5 days per week,9-11 fractions and at a total dose of 35-48Gy was delivered at the tumor margin.Results：During the treatment of gamma knife period,significant pain relief has been observed in 88.9% cases,and jaundice of 66.7% cases has faded.After 3 months,CR was 1,PR 25.The overall response rate（CR＋PR） was 32.9% and the rate of clinical benefit response（CBR）was 69.6%.The mean survival time was 5.7 months.The whole process was bearable for all the patients after allopathy.Conclusion：Gamma knife radiotherapy was a non-invasive,safe,and effective palliative therapy for advanced pancreatic cancer.

关 键 词：晚期胰腺癌 体部伽玛刀 立体定向治疗 

分 类 号：R735.9[医药卫生—肿瘤]