适形放疗联合替吉奥与吉西他滨治疗局部晚期胰腺癌的疗效观察  

Observation on the clinical efficiency of conformal radiotherapy combined with S-1 plus gemcitabine in patients with locally advanced pancreatic cancer

作　　者：刘学芬[1] 李刚[1] 冉文华[1] 张力[1] 朱川[1] 任必勇[1] 彭东[1] 刘华文[1] 莫小飞[1] 

机构地区：[1]重庆三峡中心医院肿瘤防治研究所,重庆404000

出　　处：《中国医院药学杂志》2013年第6期475-478,共4页Chinese Journal of Hospital Pharmacy

基　　金：重庆市医学重点研究室建设项目资助(编号:2007-14)

摘　　要：目的:探讨适形放疗联合替吉奥与吉西他滨治疗局部晚期胰腺癌的疗效和安全性。方法:64例局部晚期胰腺癌患者,采用替吉奥胶囊(S-1)与吉西他滨化疗方案:替吉奥40～50 mg/次,bid,第1～14天;吉西他滨800～1 000 mg·m-2,第1、8天,4周为1周期;连用1～2个周期。同步三维适形放疗从第1天开始,总剂量(DT)50.4 Gy,每天1次,每次1.8 Gy,每周5d,连续5.5周。治疗结束4周后复查CT测量病灶体积改变,检测肿瘤标志物水平,用实体瘤疗效反应的评价标准评价治疗效果,根据WHO标准评价不良反应。结果:64例晚期胰腺癌患者,均完成放化疗,无完全缓解(CR),部分缓解(PR)43.8%(28/64),稳定(SD)45.3%(29/64),进展(PD)10.9%(7/64);治疗有效率(CR+PR)为43.8%(28/64)。中位生存期10个月(8.4～11.6个月),疾病无进展生存期6.0个月(4.6～7.4个月),1年生存率为40.6%。主要不良反应表现为白细胞减少、贫血、血小板减少、恶心、呕吐和疲乏等,患者均能够耐受。结论:适形放疗联合替吉奥与吉西他滨治疗局部晚期胰腺癌近期疗效较好,不良反应可以耐受,值得临床进一步研究。OKJECTIVE To investigate the effects and side effects of regimen S-1 plus gemcitabine combined concurrent con-formal radiotherapy for patients with locally advanced pancreatic cancer. METHODS Sixty-four patients with locally advancedpancreatic cancer were enrolled. S-1 was administered at a dose of 80- 100 mg·d^-1 from day 1 to 14 and gemcitabine was ad-ministered at a dose of 800- 1 000 mg·m^-2 on d1, d8, repeated every 4 weeks. The concurrent three-dimensional conformal ra-diation therapy was delivered in 1.8 Gy daily fractions to a total dose of 50. 4 Gy over 5.5 weeks. Efficacy and toxicities wereevalualed according to RECIST criteria and WHO＇s criterion. RESULTS All the patients were eligible. Of 64 patients, 28 casesachieved PR, 29 cases achieved SD and 7 cases achieved PD. The overall response rate （CR ＋ PR） was 43.8% （28/64）. Themedian PFS was 6. 0 months （95% CI： 4. 6- 7.4 months） with a median overall survival of 10. 0 months （95% CI： 8. 4 - 11. 6months） and l-year survival rate of 40. 6%. The major adverse events included leucopenia, thrombocytopenia, anaemia, nause-a, vomiting and fatigue. CONCLUSION Regimen S-1 plus gemcitabine combined with conformal radiotherapy shows favorableefficacy for locally advanced pancreatic cancer and side effects were tolerable. The long-term results still need to be further ob- served.

关 键 词：胰腺癌 适形放疗 替吉奥 吉西他滨 

分 类 号：R969[医药卫生—药理学]