替吉奥联合三维适形放疗治疗局部晚期胰腺癌的临床观察  

Clinical Study of Oral S-1 with Synchronous Radiotherapy for Locally Advanced Pancreatic Cancer

作　　者：杨妤[1] 朱道奇[1] 苏加利[1] 

机构地区：[1]解放军第163医院肿瘤科,湖南长沙410003

出　　处：《医学临床研究》2015年第12期2314-2316,2320,共4页Journal of Clinical Research

基　　金：湖南省教育厅科学研究项目（基金号13C571）

摘　　要：【目的】探讨替吉奥同步放疗并维持化疗治疗局部晚期胰腺的有效性和安全性。【方法】收集28例经病理证实或符合临床诊断标准的局部晚期胰腺癌患者。放疗方案为应用10MV-X，肿瘤大体靶区（GTV）为肿瘤组织和转移淋巴结，放疗剂量（DT）为50Gy／25次（5周内），1次／日，同时予以替吉奥胶囊40～60mg／d，1次／日（根据患者体表面积计算：〈1．25m^2，40mg／d；≥1．25～1．5m^2，50mg／d；≥1．5m^2，60mg／d），共35d，放化疗结束后2周开始予以替吉奥单药化疗80-120mg／d，分2次服用（根据患者体表面积计算：〈1．25m^2，80mg／d;≥1．25～1．5m^2，100mg／d；≥1．5m^2，120mg／d），连续14d，休息7d为1周期，口服化疗直至病情进展或不能耐受其毒性。用实体瘤疗效反应评价标准评价治疗效果，用美国国立癌症研究所的常规毒性判定标准评价毒副反应。【结果】共入组病例28例，其中26例患者按计划治疗直至病情进展，近期治疗有效率（CR＋PR）为38．4％（10／26），肿瘤控制率（CR＋PR＋SD）为80．8％（21／26），临床获益率53．9％（14／26）。随访提示中位无进展生存期和中位生存期分别为6．3个月和12．8个月，1年生存率为46．3％。治疗过程中最常见的毒副反应为1～2度血液学毒性，非血液毒副反应主要为恶心、食欲减退。【结论】替吉奥同步放疗并维持化疗治疗局部晚期胰腺癌安全，毒副反应轻，患者临床症状可得到改善，生存改善，是一种安全有效的治疗模式，但长期治疗效果及毒副反应有待进一步研究。[Objective]To explore the efficacy and security of oral S-1 with synchronous radiotherapy plus chemotherapy for locally advanced pancreatic cancer. [Methods]： 28 patients with locally advanced pancreatic cancer confirmed by pathology or in accordance with the criteria of clinical diagnosis were collected. Radiotherapy plan was： 10MV-X, tumor gross target volume （GTV） were tumor tissues and metastatic lymph nodes, the radiation dose （DT） was 50 Gy/25 times （5 weeks）, 1 time / day, plus S-1 at a dose of 40-60 mg/d, 1 time / day （according to the patient＇s body surface area calculation;〈1.25 m^2 , 40 mg/d≥1.25-1.5 m^2 , 50 mg/d; ≥1.5 m^2 , 60 d mg/）during radiotherapy（d1-35）; 2 weeks after the end of chemoradiotherapy, the single chemotherapy S-1 was administered at a dose of 80- 120 mg/d, 2 times administered （according to the patient＇s body surface area calculation： 〈1.25 m^2 , 80 mg/d≥1.25-1.5 m^2 , 100 mg/d; ≥1.5 m^2 120 mg/d）, a total of 14 days followed by lweek rest as a treatment cycle. Oral chemotherapy were taken until disease progressed or intolerance to its toxicity occurred. Therapeutic effect evaluation standard was used to evaluate the curative effect of solid tumor response. Toxic and side effects were evaluated by conventional toxicity criteria of the National Cancer Institute , USA.[Resuhs]Twenty-six patients（26/28） finished the whole treatment upto progression. The tumor response rate （CR@ PR） was 38.4 % （10/26） and tumor control rate （CR＋ PR@ SD） was 80.8 % （21/26）. The clinical benefit rate was 53.9% （14/26）. Follow-up suggested the median progression free survival and median survival time were 6.3 months and 12.8 months. 1 year overall survival rate was 46.3~.The most common toxic effects were hematologic toxicity （1-2 degree）, the major non- hematologic toxicities were nausea and anorexia. [Conclusion]Oral S-1 with synchronous radiotherapy plus chemotherapy was a feasible and effective treatment with mild toxicity for

关 键 词：氟尿嘧啶/治疗应用 抗肿瘤药/治疗应用 放射疗法 适形 胰腺肿瘤/药物疗法 

分 类 号：R735.9[医药卫生—肿瘤]