胆囊癌术后辅助性放疗的疗效分析  

Analysis of the efficacy of postoperative radiotherapy in gallbladder cancer

作　　者：杨惊[1] 冯飞灵[1] 周海华[1] 孙永健[1] 孟岩[1] 

机构地区：[1]第二军医大学附属东方肝胆外科医院放疗中心,上海200438

出　　处：《中华肿瘤杂志》2013年第7期534-539,共6页Chinese Journal of Oncology

摘　　要：目的探讨胆囊癌患者术后放疗的疗效。方法回顾性分析84例胆囊癌根治性切除和43例术后放疗患者的临床资料。比较单纯手术组和术后放疗组患者在不同病理分期及切缘情况下的生存时间和1、3、5年生存率。结果术后放疗组中，Ⅲ期胆囊癌患者的中位生存期为16．9个月，1、3、5年生存率分别为55．7％、23．5％和18．2％；单纯手术组中，Ⅲ期胆囊癌患者的中位生存期为14．3个月，1、3、5年生存率分别为42．7％、22．6％和16．7％，差异有统计学意义（P〈0．05）。术后放疗组中，Ⅳ期胆囊癌患者的中位生存时间为9．7个月，1、3、5年生存率分别为14．2％、7．2％和7．2％；单纯手术组中，Ⅳ期胆囊癌患者的中位生存时间为6．3个月，1、3、5年生存率分别为9．8％、3．9％和1．9％，差异有统计学意义（P〈0．05）。Ⅲ、Ⅳ期患者中，术后放疗组R0和R1切除患者的1、3、5年生存率均高于单纯手术组（均P〉0．05）。胆囊癌患者术后放疗常见的毒副反应为恶心、呕吐和腹痛，予以对症支持治疗后均可顺利完成放疗。结论Ⅲ、Ⅳ期胆囊癌患者应予以术后辅助性放疗，可明显提高生存期。对于Ⅰ、Ⅱ期胆囊癌术后患者，术后放疗未明显提高生存期。Objective To summarize the experiences in gallbladder cancer treatment, evaluate the efficacy of postoperative radiotherapy, and investigate the method of improving the survival of gallbladder cancer patients. Methods One hundred and twenty-seven gallbladder cancer patients, treated in our center by radical resection （84 cases） and combined with postoperative radiotherapy （43 cases）, between June 2003 to December 2009 were included in this study. Their clinical data and follow-up results were retrospectively analyzed. According to AJCC staging criteria, the survival time and 1-, 3- and 5-year survival rates of the surgery group and the postoperative radiotherapy group at the different pathological stages and resection margin status were compared. Results The median survival time of postoperative radiotherapy patients in stage Ⅲ was 16.9 months, and the 1-year, 3-year, and 5-year survival rates were 55.7%, 23.5% and 18.2% , respectively, significantly higher than that of the simple operation group （ median survival time 14. 3 months, and 1-year, 3-year, 5-year survival rates 42.7%, 22.6% and 16.7%, respectively） （P 〈 0.05 ）. The median survival time of postoperative radiotherapy patients in stage Ⅳ, the median survival time was 9.7 months in the postoperative radiotherapy group and 6.3 months in the simple surgery group, and the 1-year survival rates were 14.2% and 9.8%, the 3-year survival rates were 7.2% and 3.9%, the 5-year survival rates were 7.2% and 1.9%, respectively, all showing a statistically significant difference （P 〈 0.05）. Among the stage Ⅲ and Ⅳ patients, all the 1-, 3- and 5-year survival rates of the postoperative radiotherapy group were higher than that of the simple R0 and R1 surgical resection group （ all P 〈 0.05 ）, but with a non-significant difference between the stage I and II patients （ P 〉 0.05 ）. The main side effects in postoperative radiotherapy patients including nausea, vomiting and abdominal pain, all were successfully alleviated by sympto

关 键 词：胆囊肿瘤 放射疗法 外科手术 治疗效果 

分 类 号：R739.63[医药卫生—肿瘤]