三维适形放疗辅助外科减黄手术治疗进展期胰头癌  

The application of three-dimensional conformal radiotherapy-assisted cholangioenterostomy in treating patients with advanced pancreatic head carcinoma

作　　者：王利民[1] 王海玲[2] 彭鹏[1] 赵逸超[1] 祝朝前 

机构地区：[1]唐山市工人医院肝胆外科,河北唐山063000 [2]河北省唐山市卫生监督所

出　　处：《中华胰腺病杂志》2016年第5期294-297,共4页Chinese Journal of Pancreatology

摘　　要：目的：探讨三维适形放疗（3D-CRT）对经外科减黄手术后胰头癌患者的辅助治疗效果。方法回顾性分析2006年1月至2010年1月期间唐山市工人医院肝胆外科收治的临床诊断为晚期胰头癌并接受姑息减黄手术治疗的88例患者临床资料，根据术后是否接受放化疗分为对照组（34例）、化疗组（23例）、放疗组（31例）。对照组患者术后未进行放疗或化疗；化疗组患者术后接受化疗，即在第1天、第8天静脉滴注吉西他滨1000 mg／m2，第1天静脉滴注顺铂80 mg／m2，21 d为1个周期，共3个周期，每个周期间隔7 d；放疗组患者术后行三维适形放疗，照射总剂量为3000-4800 cGy，每天治疗1次，连续治疗6 d后休息1 d，10-15 d完成治疗。分析各组患者的治疗效果及生存时间。结果对照组、化疗组、放疗组患者术后癌性疼痛发生率分别为52．9％、39．1％、9．7％，放疗组显著低于对照组及化疗组，差异均有统计学意义（P值均＜0．05）；轻微消化道症状发生率分别为8．8％、73．9％、16．1％，骨髓抑制发生率分别为0、82．6％、9．7％，放疗组较对照组显著升高，但显著低于化疗组，差异均有统计学意义（P值均＜0．05）。对照组患者1、2、3年术后生存率分别为30．1％、8．3％、0，化疗组分别为35．3％、14．8％、0，放疗组分别为46．4％、21．1％、3．6％，放疗组患者的术后生存率显著高于对照组及化疗组，差异具有统计学意义（ P值均＜0．05）。结论三维适形放疗对晚期胰头癌具有姑息治疗的作用，可延长部分晚期胰头癌患者的生存时间。Objective To investigate the adjuvant therapeutic efficacy of three-dimensional conformal radiotherapy （3D-CRT） in treating patients who underwent surgical operation for biliary drainage.Methods Clinical data on 88 clinically diagnosed advanced pancreatic head carcinoma patients who received palliative biliary drainage surgery in Tanshan Gongren Hospital from Jan 2006 to Jan 2010 were retrospectively reviewed. The cases were categorized according to the treatment into control group （ n=34 ） , chemotherapy group （ n=23 ） and radiotherapy group （ n=31 ） . The patients in control group received no chemotherapy or radiotherapy after biliary drainage surgery.The patients in chemotherapy group received chemotherapy of 1 000 mg/m2 gemcitabine intravenous infusion on day 1 and day 8, 80 mg/m2 cisplatin intravenous infusion on day 1 for each treatment cycle.Each cycle lasted for 21 days and was repeated for 3 cycles at an interval of 7 days in a treatment course.Patients in radiotherapy group received 3D-CRT for 6 successive days followed by an interval on the 7th day.The treatment course was completed within 10-15 days with the total dosage of 3 000-4 800 cGy.The therapeutic effects and survival time were analyzed.Results The incidence of cancerassociated pain was 52.9%, 39.1%and 9.7%in control group, chemotherapy group and radiotherapy group, respectively, which was significantly lower in radiotherapy than that in the other two groups （both P〈0.05）. The incidence of mild gastrointestinal symptoms was 8.8%, 73.9% and 16.1%, respectively, and that of bone marrow suppression was 0%, 82.6% and 9.7%, respectively, which were both significantly lower in radiotherapy group than in chemotherapy group （both P〈0.05）.The 1-year, 2-year and 3-year survival rate was 30.1%, 8.3%, 0% in control group, 35.3%, 14.8%, 0% in chemotherapy group and 46.4%, 21.1%, 3.6%in radiotherapy group, which in radiotherapy group was significantly higher than that in control group and chemotherapy group （all P〈0.05）.Con

关 键 词：胰腺肿瘤 放射疗法 适形 肿瘤辅助疗法 

分 类 号：R735.9[医药卫生—肿瘤]