放疗对胰腺癌患者胰腺外分泌功能的影响  

The influence of pancreatic exocrine function following radiation therapy in patients with pancreatic cancer

作　　者：陈仲卿 陈晓[1] 罗妍[1] 郭小陪 周平[1] 

机构地区：[1]空军总医院肿瘤放疗科,北京100142

出　　处：《空军医学杂志》2015年第5期309-312,共4页Medical Journal of Air Force

摘　　要：目的研究放疗对胰腺癌患者胰腺外分泌功能的影响。方法前瞻性入组30例接受立体定向放射治疗的胰腺癌患者,通过检测放疗前后胰腺癌患者粪弹性蛋白酶1(fecal elastase-1,FE1)水平来评估患者胰腺外分泌功能。结果放疗前后胰腺癌患者FE1中位数(四分位数间距)分别为99.0(48.3,320.6)μg/g、56.1(41.9,119.8)μg/g,放疗后胰腺癌患者FE1水平显著下降(P<0.001)。胰头癌及胰体尾部癌患者放疗前FE1中位数(四分位数间距)分别为52.2(45.4,195.2)μg/g、315.1(71.5,355.6)μg/g,放疗前胰头癌FE1水平较胰体尾部癌低(P<0.05)。根据FE1评价胰腺外分泌功能标准,本研究中胰腺癌患者放疗前后胰腺外分泌功能不全(exocrine pancreatic insufficiency,EPI)发生率分别为66.7%、100.0%,其中放疗前胰腺癌患者轻中度及重度胰腺外分泌功能不全发生率分别为16.7%、50.0%,放疗后轻中度及重度胰腺外分泌功能不全发生率分别为26.7%、73.3%。结论放射治疗可进一步降低胰腺外分泌功能。因此,监测接受放疗的胰腺癌患者FE1水平,评估其胰腺外分泌功能,对于指导临床补充胰酶等治疗具有重要意义。Objective To assess pancreatic exocrine function （PEF） following radiation therapy in patients with pancreatic cancer. Methods Thirty eligible patients with pancreatic cancer were enrolled in this study. PEF was evaluated by fecal elastase-1 （FE1） for all patients before and after radiation therapy. Results The FE1 medians （interquartile range） was 99.0 （48.3, 320.6） μg/g before radiotherapy in patients with pancreatic cancer. It was 56.1 （41.9, 119.8） μg/g after radiotherapy. FE1 level decreased significantly during radiation therapy in patients with pancreatic cancer （P〈0.001） . FE1 levels in patients with pancreatic head cancer was less than that in patients with pancreatic body and tail cancer before radiotherapy[52.2 （45.4, 195.2） μg/g vs 315.1 （71.5,355.6） μg/g, P〈0.05]. The incidences of pancreatic exocrine insufficiency （EPI） before and after radiotherapy in patients with PC were 66.7% and 100.0%, respectively. The incidence of mild to moderate EPI and serve EPI before radiotherapy in patient groups were 16.7% and 50.0%, respectively. After radiotherapy, the rates of mild to moderate and severe pancreatic exocrine insufficiency were 26.7%, and 73.3% respectively. Conclusion Radiation therapy reduce pancreatic exocrine function in patients with pancreatic cancer. It is recommended to monitor pancreatic exocrine function in patients with pancreatic cancer, which could guide patients to receive pancreatic enzyme replacement therapy in time.

关 键 词：胰腺癌 放疗 胰腺外分泌功能 粪弹性蛋白酶1 

分 类 号：R435.9[医药卫生—临床医学]