恶性梗阻性黄疸胆管引流术后应用调强放疗全程同步低剂量卡培他滨的临床研究  

Clinical study of intensity modulated radiation therapy and low-dose capecitabine in patients with malignant obstructive biliary drainage

作　　者：李瑞卿[1] 王书山[1] 叶静[1] 周长杰[1] 

机构地区：[1]泰安市肿瘤防治院放疗科,山东泰安271000

出　　处：《泰山医学院学报》2016年第10期1090-1093,共4页Journal of Taishan Medical College

摘　　要：目的观察经皮肝胆管穿刺引流术(PTCD)应用调强放疗(IMRT)同步全程低剂量卡培他滨(Cap)治疗恶性梗阻性黄疸(MOJ)的临床疗效及不良反应。方法选取2009年8月至2013年10月于我院就诊的恶性梗阻性黄疸患者94例,随机分为两组,各47例。研究组采用PTCD加IMRT同步Cap口服,对照组采用PTCD加IMRT治疗。比较两组的治疗有效率和6个月、12个月、18个月、24个月生存率以及不良反应的发生情况。结果研究组治疗有效率为87.2%,显著高于对照组74.5%(P<0.05)。两组6个月、12个月生存率差异无统计学意义(82.98%vs78.72%,59.57%vs 46.81%,P>0.05),但联合组18个月、24个月生存率均显著高于对照组(38.30%vs14.89%,6.45%vs2.15%),差异有统计学意义(P<0.05)。两组的中位生存时间分别为14.2个月和10.0个月(P<0.05)。两组发生的胃肠道反应、骨髓抑制等不良反应无统计学意义(P>0.05)。结论 PTCD加IMRT同步Cap治疗MOJ安全有效,可延长患者生存时间,提高生活质量。Objective： Objective to observe the clinical effect and adverse reaction of percutaneous biliary drainage（ PTCD） plus intensity modulated radiation therapy（ IMRT） in the treatment of malignant obstructive jaundice（ MOJ） with synchronous Capecitabine（ Cap）. Methods： 94 patients with malignant obstructive jaundice in our hospital from August 2009 to October 2013 were randomly divided into two groups,each of 47 cases. The study group was treated with PTCD plus IMRT synchronous Cap,the control group was treated with PTCD plus IMRT. The treatment efficiency and 6、12、18、24months survival rate and adverse reaction were compared between the two groups. Results： the effective rate of the study group was 87. 2%,which was significantly higher than that of the control group 74. 5%（ P〈0. 05）. Two groups of six month survival rate differences had no statistical significance（ 82. 98% vs78. 72%,P〉0. 05）,but the combined group,12 months,18 months and 24 months survival rates were significantly higher than those in the control group（ 59. 57%vs46. 81%; 38. 30% vs14. 89%,6. 45% vs2. 15%） differences in the have statistical significance（ P〈0. 05）. The median survival time was 14. 2 months and 10 months（ P〈0. 05） in the two groups. Adverse reactions such as gastrointestinal reaction and bone marrow suppression occurred in the two groups were not statistically significant（ P〉0. 05）. Conclusion：PTCD plus IMRT synchronous Cap treatment of MOJ is safe and effective,can prolong the survival time of patients and improve the quality of life.

关 键 词：恶性梗阻性黄疸 经皮肝穿刺胆管引流 调强放疗 卡培他滨 

分 类 号：R730.5[医药卫生—肿瘤]