伽玛刀联合GP方案治疗局部进展期胰腺癌疗效观察  

Efficacy of gamma knife combined GP chemotherapy regimens in treatment of locally advanced pancreatic cancinoma

作　　者：王磊[1] 李灵招[2] 王晓芳[3] 单国用[1] 张松[1] 吴晓东[4] 李怀玉[1] 张大勇[1] 姚坤[1] 

机构地区：[1]郑州人民医院放疗科,河南郑州450003 [2]郑州市中心医院检验科 [3]郑州大学第三附属医院检验科 [4]郑州市儿童医院病理科

出　　处：《医药论坛杂志》2015年第4期58-61,共4页Journal of Medical Forum

摘　　要：目的探讨伽玛刀联合GP方案化疗治疗局部进展期胰腺癌的疗效。方法 75例不能手术切除局部进展期胰腺癌(LAPC)患者随机分为2组:A组(伽玛刀+化疗组)39例,伽玛刀联合"GP方案"全身化疗,具体化疗方案同化疗组;B组(化疗组)36例,应用"GP方案"全身化疗,具体:吉西他滨注射液1 000 mg/m2d1,8+顺铂注射液75 mg/m2分d1-4应用,21d为1疗程。2组患者均按期完成4个周期化疗后进行疗效评价。患者治疗后1、2、3个月行增强CT扫描及CA199复查,以后为每3个月1次,共随访30个月。结果 A组临床受益率:B组临床受益率=84.62%:58.33%(χ2=6.414,P=0.011<0.05),2组中位生存期为13.00月:9.00月,平均生存时间A组为15.13个月:B组为12.15个月(P=0.035<0.05)。2组75例病人中均按计划顺利完成,无1例术后及化疗后出现胰漏、出血、脏器穿孔及Ⅳ度骨髓抑制等严重并发症。结论伽玛刀联合GP方案治疗局部进展期胰腺癌是一种新的有效且安全的治疗方案,值得进一步探讨。Objective To explore the clinical efficacy of gamma knife combined GP chemotherapy regimens for the treatment of locally advanced pancreatic cancinoma. Methods Totally 75eases of locally advanced pancreatic cancinoma （LAPC） patients which can not be removed surgically were randomly divided into two groups： group A 39 eases （gamma knife ＋ chemotherapy group ） , which conduct Gamma knife combined ＂GP＂ systemic chemotherapy, chemotherapy regimens as chemotherapy group; Group B 36 eases （chemotherapy group） , which applicate ＂ GP＂ systemic chemotherapy. Specifically： gemcitabine 1000 mg/m2 dl, 8 cisplatin 75 mg/m2 dlpoints 4 application, 21 days to 1 course of treatment. 2 groups of patients evaluate the curative effect after four cycles of chemotherapy curative termly. Patients conduct enhancement CT scanning and CA199 review after 1,2,3 months treatment：, once every three months, a total of 30 months of follow - up. Results Clinical benefit response of group A ： clinical benefit response of group B = 84. 62% ：58. 33% （ χ^2 = 6. 414, P = 0. 011 〈 0. 05）, median survival time of two groups was 13.00 months： 9.00 months, the average survival time in group A was 15. 13 months, group B was 12. 15months （P = 0. 035 〈 0.05 ）. In the two groups, 75 cases of patients were completed smoothly as planned, no one case have serious complications such as pancreatic leakage, bleeding, viscera perforation and Ⅳ bone marrow suppression after chemotherapy operative. Conclusion Gamma knife combined GP chemotherapy regimens is a safe and effective in the treatment of locally advanced pancreatic cancinoma.

关 键 词：局部进展期胰腺癌 伽玛刀 化疗 

分 类 号：R657.5[医药卫生—外科学]