老年Ⅳ期胰腺癌高剂量少分次放疗的效果观察  

Efficacy of high-dose hypofractionated radiotherapy in elderly patients with stage Ⅳ pancreatic cancer

作　　者：任刚[1] 王颖杰[1] 邸玉鹏[1] 常冬姝[1] 康晓黎[1] 朱夫海[1] 吴伟章[1] 刘纤 夏廷毅[1] 

机构地区：[1]中国人民解放军空军总医院肿瘤放疗科,北京100142

出　　处：《临床肝胆病杂志》2016年第5期873-875,共3页Journal of Clinical Hepatology

摘　　要：目的评估高剂量少分次放疗模式治疗老年Ⅳ期胰腺癌的疗效及毒副反应。方法收集2011年9月-2015年5月于中国人民解放军空军总医院肿瘤放疗科就诊的胰腺癌伴远处转移患者的临床资料,所有患者接受螺旋断层放疗高剂量少分次模式治疗。通过随访获取疗效及毒副反应,依据NCI-CTCAE 4.02标准行不良反应评价。生存分析采用Kaplan-Meier法。结果共33例65岁以上患者接受高剂量少分次模式放疗,30例获得随访,获访率91.0%,其中位生存时间9个月,1年生存率为24.0%,疼痛缓解率80.0%(20/25)。17例患者可评价胰腺病灶治疗效果,其中部分缓解4例(23.5%),稳定12例(70.6%),进展1例(5.9%)。毒副反应中血液学反应3级占6.7%(2/30),无2级以上消化道反应。结论采用高剂量少分次模式治疗老年Ⅳ期胰腺癌,副反应可接受,可缓解患者癌痛,有延长生存时间的趋势。Objective To investigate the efficacy and toxic and adverse effects of high- dose hypofractionated radiotherapy in elderly patients with stage Ⅳ pancreatic cancer. Methods The clinical data of the patients with pancreatic cancer and distant metastasis who were admitted to our hospital from September 2011 to May 2015 were collected,and all the patients underwent high- dose hypofractionated helical tomotherapy. The data on efficacy and toxic and adverse effects were obtained through follow- up,and the evaluation of adverse effects was performed according to National Cancer Institute- Common Terminology Criteria for Adverse Events version 4. 02. The Kaplan- Meier method was used for survival analysis. Results A total of 33 patients older than 65 years received the high- dose hypofractionated radiotherapy.Of all the patients,30 received follow- up visits,and the follow- up rate was 91. 0%. The median survival time was 9 months,the 1- year overall survival rate was 24. 0%,and the rate of pain relief was 80. 0%（ 20 /25）. The treatment outcome of pancreatic lesions could be evaluated in 17 patients,among whom 4（ 23. 5%） achieved partial remission,12（ 70. 6%） achieved stable disease,and 1（ 5. 9%） experienced progression. As for toxic and adverse effects,the incidence rate of grade 3 hematologic toxicity was 6. 7%（ 2 /30）,and no patients experienced grade 2 upper gastrointestinal reactions. Conclusion In elderly patients with stage IV pancreatic cancer,high- dose hypofractionated radiotherapy has tolerable toxic and adverse effects and can relieve cancer pain and prolong survival time.

关 键 词：胰腺肿瘤 放射剂量分次 预后 老年人 

分 类 号：R735.9[医药卫生—肿瘤]