术中放疗在术中不可切除T_4期胰腺癌的应用研究  

Application of Intraoperative Radiotherapy for Unresectable Pancreatic Cancer Stage T_4 During the Operation

作　　者：翟医蕊[1] 冯勤付[1] 王成锋[1] 陈辛元[1] 胡志辉[1] 李明辉[1] 张永谦[1] 马攀[1] 范诚诚[1] 单毅[1] 赵宏[1] 白晓枫[1] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院,北京100021

出　　处：《肿瘤学杂志》2012年第3期206-210,共5页Journal of Chinese Oncology

摘　　要：[目的]对术中不可切除T4期胰腺癌进行单纯术中电子线放疗研究,探讨其安全性和疗效。[方法]2009年12月～2011年7月共入组16例术中不可切除的T4期胰腺癌。术中行电子线放疗,中位剂量18Gy,术后依病情决定是否给予化疗。分析手术时间、住院时间、不良反应、局部控制以及生存情况。[结果]手术中位时间180min,术后住院中位时间10.5d,未观察到3度以上的不良反应。1年局部控制率80.0%,1年生存率12.5%,中位生存期9.5个月。[结论]对术中不可切除的T4病变进行单次16～20Gy以上的术中放疗有效且耐受性好,能达到术后同步放化疗相似的生存率及局部控制率。但整体远处转移率高,建议对能耐受者应给予化疗。[Purpose]To estimate the safety and effect of the electron intraoperative radiotherapy in unresectable pancreatic cancer stage T4 during the operation.[Methods] From December 2009 to July 2011,16 patients with unresectable pancreatic cancer stage T4 during operation were enrolled.Electron intraoperative radiotherapy were delivered with median radiation dose of 18Gy,as well as postoperative chemotherapy when necessary.The time of the operation,hospitalization,side effect,local control and survival were analyzed.[Results] The median duration of the operation and the hospitalization after surgery were 180 minutes and 10.5 days respectively.There was no severe than grade 3 toxicity.One year local control and survival were 80.0% and 12.5% respectively.The median survival was 9.5 months.[Conclusion] A median dose of 18Gy intraoperative radiotherapy is well tolerable and effective,the local control and survival are equally to those with postoperative concurrent radiochemotherapy.Postoperative chemotherapy are recommended for such patients because of high metastatic rate.

关 键 词：胰腺肿瘤 术中放疗 不良反应 

分 类 号：R735.9[医药卫生—肿瘤]