老年局部进展期胰腺癌患者放化疗的临床观察  

Clinical observation of chemoradiotherapy in elderly patients with locally advanced pancreatic cancer

作　　者：陈方宇 丁丽娟[2] 许耀麟 孙海涛 郭曦 何健 吴莉莉 CHEN Fangyu;DING Lijuan;XU Yaolin;SUN Haitao;GUO Xi;HE Jian;WU Lili(Department of Radiation Oncology,Zhongshan Hospital Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院放疗科,上海200032 [2]吉林大学第一医院放疗科,130031 [3]复旦大学附属中山医院胰腺外科,200032 [4]复旦大学附属中山医院放射科,200032 [5]复旦大学附属中山医院肿瘤内科,200032

出　　处：《临床肿瘤学杂志》2024年第10期973-977,共5页Chinese Clinical Oncology

基　　金：复旦大学附属中山医院“卓越住院医师”临床博士后项目、国家自然科学基金青年项目(82202935);复旦大学附属中山医院青年基金项目(2023ZSYY-011)。

摘　　要：目的观察年龄大于65岁的老年局部进展期胰腺癌患者行放化疗的疗效及安全性。方法回顾性分析2019年6月至2023年5月在复旦大学附属中山医院年龄大于65岁且不可手术切除的局部晚期胰腺癌患者。通过医院电子病历系统,整理患者接受治疗后的疗效及安全性数据,并对患者进行定期随访获取生存数据。参照实体肿瘤疗效评价标准(RECIST)1.1评估近期疗效,参照美国癌症常见不良反应事件评价标准(CTCAE)5.0进行安全性评估,采用Kaplan-Meier法绘制生存曲线。分析患者的近期疗效、不良反应及预后情况。结果61例符合入组条件的局部晚期胰腺癌患者纳入分析。放疗结束后1个月评估近期疗效,客观缓解率(ORR)为12.9%,疾病控制率(DCR)为81.5%。治疗期间,35例患者发生了与治疗相关的不良反应事件,其中13例患者发生3级血液学毒性,均为骨髓抑制,经对症支持治疗后均顺利康复。无1例患者发生4级或5级治疗相关的不良事件。中位随访时间29.4个月,至随访截止时间,11例患者维持疾病稳定或缓解,7例无法评估,43例发生疾病进展。61例患者的中位无进展生存期为12.2个月(95%CI:9.2~19.1个月),中位总生存期为22.5个月(95%CI:21.1~27.4个月)。结论年龄大于65岁局部进展期胰腺癌放化疗的疗效显著,安全性耐受,可成为老年局部进展期胰腺癌患者的潜在理想治疗方案。Objective To observe the efficacy and safety of chemoradiotherapy for locally advanced pancreatic cancer in patients over 65 years old.Methods Patients aged more than 65 years old with unresectable locally advanced pancreatic cancer in Zhongshan Hospital Affiliated to Fudan University from June 2019 to May 2023 were retrospectively analyzed.The efficacy and safety data of patients after treatment were sorted out through the hospital electronic medical record system,and the patients were followed-up regularly to obtain survival data.The short-term efficacy was evaluated according to the Response Evaluation Criteria for Solid Tumors(RECIST)1.1,and the safety was evaluated according to the Common Adverse Event Evaluation Criteria for Cancer in the United States(CTCAE)5.0.The survival curve was plotted by Kaplan-Meier method.The efficacy,adverse reactions and prognosis of the patients were analyzed.Results A total of 61 patients with locally advanced pancreatic cancer who met the inclusion criteria were included in the analysis.One month after the end of chemoradiotherapy,the short-term efficacy was evaluated with an objective response rate(ORR)of 12.9%and a disease control rate(DCR)of 81.5%.During the treatment,35 patients experienced treatment-related adverse events,and 13 patients experienced grade 3 treatment-related adverse events(all bone marrow suppression).All patients recovered smoothly after symptomatic supportive treatment.No patient experienced grade 4 or 5 treatment-related adverse events.The median follow-up time was 29.4 months.To the end of follow-up,11 patients maintained disease stability or remission,7 patients could not be evaluated,and 43 patients experienced disease progression.The median progression-free survival of the 61 patients was 12.2 months(95%CI:9.2-19.1 months),and the median overall survival was 22.5 months(95%CI:21.1-27.4 months).Conclusion For patients aged 65 years or older with locally advanced pancreatic cancer,chemoradiotherapy has significant efficacy and tolerable safety,and c

关 键 词：局部进展期胰腺癌 老年患者 放射治疗 化学治疗 

分 类 号：R735.9[医药卫生—肿瘤]