81例胰腺癌后程加量三维适形放疗的疗效分析  

Efficacy Analysis of Three-dimensional Conformal Radiotherapy with Increasing Dose in Late Course in 81 Cases of Pancreatic Cancer Patients

作　　者：李光[1] 于洋洋[1] 韩冲[1] 乔俏[1] 党军[1] 顾菲[1] 李建军[1] 姚雷[1] 

机构地区：[1]中国医科大学附属第一医院放疗科,沈阳110001

出　　处：《中国医科大学学报》2012年第12期1134-1137,1143,共5页Journal of China Medical University

基　　金：沈阳市科技局科学技术项目(F11-264-1-41)

摘　　要：目的观察Ⅱ、Ⅲ期胰腺癌后程加量三维适形放射治疗的临床疗效。方法采用后程加量三维适形放射治疗技术治疗81例Ⅱ、Ⅲ期胰腺癌患者。观察患者的疼痛缓解率、血清CA19-9水平改变及生存率。结果后程加量三维适形放疗后胰腺癌患者疼痛缓解率为76.2%;CA19-9平均值从治疗前的(383.6±126.7)U/mL下降到治疗后的(83.5±46.1)U/mL,差异有统计学意义(P<0.01)。放疗后胰腺癌患者1、2、3、5年生存率分别为71.6%、28.4%、19.8%、3.7%。单因素分析显示:治疗前SUV值、临床分期、放疗剂量及进行过2个以上周期化疗是影响胰腺癌患者放疗预后的重要因素;多因素分析发现:治疗前SUV值和放疗剂量是独立预后因素。放疗过程中约56.8%的患者出现Ⅰ、Ⅱ级上消化道反应;放疗后约11.1%的病例发生消化道溃疡。结论后程加量三维适形放疗可明显改善局部晚期胰腺癌患者的生活质量、提高患者的生存率,是Ⅱ、Ⅲ期胰腺癌的主要治疗手段。Objective To observe the clinical efficacy of three-dimensional confomlal radiotherapy with increasing dose in late course for patients with stage Ⅱ , Ⅲ pancreatic cancer. Methods A total of 81 cases of stage Ⅱ or Ⅲ pancreatic cancer patients treated with three- dimensional confomlal radiotherapy with increasing （lose in late course were recruited for the study. Remission rate of pancreatic cancer pa- tients with pain, serum CA 19-9 level change and survival tale were observed. Results Mter the treatment, remission rate of pancreatic can- cer patients with pain was 76.2% ;average serum CA19-9 level significantly dropped from 383.6 ± 126.7 U/mL before treatment to 83.5 ± 46.1 U/mL ＇after treatment （P 〈 0.001 ）. 1-, 2-, 3- and 5-year survival rate of pancreatic cancer patients ＇after radiotherapy were 71.6%, 28.4%, 19.8% ,and 3.7% ,respectively. Univariate analysis showed that SUV value before twatment,clinical stage,radiation dose and over two cycles （including 2 cycles） chemotherapy were prognostic factors for pancreatic cancer patients with radiotherapy;multivariate analysis found thai the SUV value hefore twatment and radiotherapy dose was an independent prognostic factor. Approximately 56.8% of the patients had I , Ⅱ levd gastrointestinal reactions during the radiotherapy,and gastrointestinal ulcers were observed in approximately 11.1% of the cases ＇after radiotherapy. Conclusion Throe-dimensional conformal radiotherapy with inereasing dose in late course can siguificantly improve the life quality and the survival rate in locally advanced panematic cancer patients, whieh could be a major treatment for stage Ⅱ ,Ⅲ pan- creatic cancer patients.

关 键 词：胰腺癌 三维适形放疗 预后 

分 类 号：R735.9[医药卫生—肿瘤] R730.55[医药卫生—临床医学]