胰腺癌梗阻性黄疸患者胆道内支架置入术后放化疗疗效分析  

Chemoradiotherapy for unresectable pancreatic cancer patients after percutaneous transhepatic cholangiodrainage

作　　者：吴杰[1] 宋磊[1] 赵丹懿[1] 郭冰[1] 刘静[1] 

机构地区：[1]大连医科大学附属第二医院介入科,辽宁省116000

出　　处：《中华普通外科杂志》2014年第8期626-629,共4页Chinese Journal of General Surgery

基　　金：辽宁省科技局计划基金资助项目（2010225034）

摘　　要：目的 探讨胰腺癌合并梗阻性黄疸患者经皮肝穿胆道内支架引流后抗肿瘤治疗的疗效.方法 2005年9月至2012年12月,共有47例确诊为胰腺癌并出现梗阻性黄疸的患者行PTCD加支架治疗,按照术后治疗方案分为支持治疗组与后续抗肿瘤治疗（放疗、化疗或放化疗）组,其中支持治疗组有26例患者,后续抗肿瘤治疗组有21例.采用Kaplan-Meier方法进行生存分析,Log-rank检验比较生存曲线差异.结果 接受经皮肝穿胆道引流术治疗的患者中位总生存期为7.19个月.其中后续抗肿瘤治疗组患者中位总生存期明显优于支持治疗组患者（9.07个月比5.52个月,P=0.017）.后续抗肿瘤治疗组中有12例（57％）患者只接受一种治疗方案（放疗或化疗）,有9例（43％）患者同时接受放疗和化疗,这两组的中位总生存期分别为8.31及11.15个月（P=0.325）.结论 胰腺癌合并梗阻性黄疸的患者在经皮肝穿胆道引流术后行后续抗肿瘤治疗比单纯支持治疗在总生存期上更能获益.Objective To evaluate the efficacy of chemoradiotherapy in patients with unresectable pancreatic cancer who were previously treated with PTCD.Methods From September 2005 to December 2012,47 unresectable pancreatic cancer patients with obstructive jaundice were enrolled in this study.They were divided into two groups.21 patients received after PTCD chemotherapy or radiation,or chemoradiotherapy.26 patients in support care group received only nutrition,analgesia and other related support treatment.Survival analysis was performed with Kaplan-Meier statistics.Differences in survival between the groups were assessed for statistical significance with the log-rank test.Results The median overall survival time of patients after PTCD was 7.19 months.The median overall survival time of chemoradiation group was 9.07 months,which was higher than that of support care group （5.52 months）,P=0.017.12 patients received single therapy （either chemo or radiation）,and 9 patients received chemoradiotherapy.The median overall survival times were 8.31 months and 11.15 months,respectively （P =0.325）.Conclusions Post PTCD chemoradiotherapy helps prolong the survival time in unresectable pancreatic cancer patients.

关 键 词：胰腺肿瘤 黄疸 阻塞性 引流术 化放疗 

分 类 号：R735.9[医药卫生—肿瘤]