非手术治疗晚期胰腺癌206例临床分析  

Clinical Analysis of 206 Patients with Advanced Pancreatic Cancer Treated with Nonsurgical Therapy

作　　者：陈坚[1] 徐周敏[1] 裴峰[2,3] 贺宁[1] 孔祥军[1] 瞿琴[1] 

机构地区：[1]中国人民武装警察部队上海市总队医院肿瘤科,上海市201103 [2]中国人民武装警察部队上海市总队医院 [3]特检科,上海市201103

出　　处：《中国肿瘤临床》2011年第23期1453-1457,共5页Chinese Journal of Clinical Oncology

基　　金：卫生部科研项目基金(编号:WKJ2006-1-007)资助

摘　　要：目的:探讨晚期胰腺癌各种非手术治疗模式的疗效。方法:对2004年4月至2010年10月收治的206例晚期胰腺癌患者进行回顾性研究。结果:立体定向放射、高强度聚焦超声、化学治疗、立体定向放射+化学治疗、高强度聚焦超声+化学治疗的近期有效率分别为37.18%(29/78)、28.57%(12/42)、26.67%(8/30)、79.31%(23/29)、77.78%(21/27),联合治疗的效果明显优于单纯治疗(P<0.05)。各组临床获益反应率分别为48.71%(38/78)、88.09%(37/42)、30.00%(9/30)、82.76%(24/29)、85.19%(23/27),高强度聚焦超声治疗优于立体定向放射治疗(P<0.01),而联合治疗的临床获益亦明显优于单纯立体定向放射治疗或化疗(P<0.01)。高强度聚焦超声治疗不良反应最轻(P<0.01)、立体定向放射治疗+化学治疗最重(P<0.01),其余各组间差异无统计学意义(P>0.05)。各组中位生存期分别为10.6、7.6、6.9、15.3、13.6个月,接受联合治疗患者的生存期明显优于仅接受单纯治疗的患者(P<0.05),联合治疗中接受立体定向放射治疗+化学治疗的患者可获得更长的生存(P<0.05)。结论:立体定向放射治疗、高强度聚焦超声、化学治疗均为晚期胰腺癌患者可选择的有效手段,联合治疗效果较单纯治疗佳。其中单纯高强度聚焦超声治疗不良反应较轻,对于一般情况较差患者是一种较好的姑息治疗手段,而对于一般情况较好的患者,接受立体定向放射治疗+化学治疗是最佳治疗选择。Objective： To compare the therapeutic efficacy of non-surgical treatments for advanced pancreatic cancer. Methods： Data of 206 patients with advanced pancreatic cancer treated from April 2004 to October 2010 were examined in this retrospective study. Results： The response rates to the various treatment options were 37.18% for stereotactic radiosurgery, 21.43% for high-intensity focused ultrasound, 26.67% for chemotherapy, 79.31% for stereotactic radiotherapy plus chemotherapy, and 61.53% for high-intensity focused ultrasound plus chemotherapy. The clinical efficacy of combination therapy was superior to that of any single treatment （ P 〈 0.05）. Clinical benefit response （ CBR ） rates were 48.71%, 88.09%, 30.00%, 82.76% and 85.19%, respectively. High-intensity focused ultrasound therapy was superior to stereotactic radiation （ P 〈 0.01 ）, while the clinical benefit of combination therapy was significantly better than the benefits observed following single stereotactic radiotherapy or chemotherapy （ P 〈 0.01 ）. The rate of toxic side effects were the lowest in the group treated by high-intensity focused ultrasound therapy （ P 〈 0.01 ） and was the highest in patients treated by stereotactic radiotherapy plus chemotherapy （ P 〈 0.01 ）. There were no significant differences among the other groups （ P 〉 0.05 ）. The median survival was 10.6, 7.6, 6.9, 15.3, and 13.6 months, respectively. The survival of the patients receiving the combination therapies was longer than the survival of patients treated by monotherapy （ P 〈 0.05 ）, and the patients in the combination stereotactic radiothera- py plus chemotherapy group exhibited the longest survival （ P 〈 0.05 ）. Conclusion： Stereotactic radiation therapy, high-intensity fo- cused ultrasound, and chemotherapy were all effective treatments for patients with advanced pancreatic cancer. The efficacy of com- bined therapy was superior to any single treatment alone. Side effects of the high-intensity focused ultrasound t

关 键 词：胰腺恶性肿瘤 立体定向放射治疗 高强度聚焦超声 化学治疗 

分 类 号：R735.9[医药卫生—肿瘤]