体部立体定向放疗联合化疗治疗局部晚期胰腺癌的临床疗效评价  

Evaluation of clinical efficacy of stereotactic body radiotherapy combined with chemotherapy for locally advanced pancreatic cancer

作　　者：王谦 王亚婷 吴云龙 Wang Qian;Wang Yating;Wu Yunlong(Department of General Surgery,Weinan Central Hospital,Weinan 714000,Shaanxi Province,China;Department of Gastroenterology,Weinan Central Hospital,Weinan 714000,Shaanxi Province,China)

机构地区：[1]渭南市中心医院普通外科,渭南714000 [2]渭南市中心医院消化内科,渭南714000

出　　处：《中国基层医药》2025年第3期359-363,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨在治疗局部晚期胰腺癌患者时,体部立体定向放疗与化疗联合应用的临床效果。方法本研究为前瞻性随机对照研究,共纳入陕西省渭南市中心医院2020年1月至2022年6月收治的局部晚期胰腺癌患者80例。患者采取摸球法随机分为两组,对照组(n=40)接受化疗及常规药物治疗,观察组(n=40)在对照组基础上联合体部立体定向放疗,并对每例患者随访1年。比较两组患者的胰腺癌局部控制率(LCR)、血清癌抗原19-9水平(CA19-9)、癌胚抗原(CEA)、腹痛缓解率、黄疸消退率、不良反应发生率和一年生存率。结果观察组患者局部控制率达到85.00%(34/40),高于对照组,差异有统计学意义(χ^(2)=5.23,P<0.05)。治疗后观察组CA19-9、CEA水平低于对照组,差异均有统计学意义(χ^(2)=2.60、3.97,均P<0.001);观察组的一年存活率达到65.00%(26/40),高于对照组的42.50%(17/40),差异有统计学意义(χ^(2)=4.07,P<0.05)。而在不良反应发生率方面,两组之间差异均无统计学意义(χ^(2)=2.58、0.05、0.39、2.05,均P>0.05)。结论体部立体定向放疗联合化疗在局部晚期胰腺癌患者中表现出较好的治疗效果,同时并未显著增加不良反应的风险。因此,这种联合治疗方案可作为局部晚期胰腺癌治疗的有效选择。Objective To investigate the clinical efficacy of stereotactic body radiotherapy combined with chemotherapy in the treatment of patients with locally advanced pancreatic cancer.Methods This study is a prospective randomized controlled study that included 80 patients with locally advanced pancreatic cancer admitted to Weinan Central Hospital from January 2020 to June 2022.Patients were randomly divided into two groups using a drawing lots method:the control group(n=40)received chemotherapy and conventional medication,while the observation group(n=40)received stereotactic body radiotherapy in addition to the treatments in the control group.Each patient was followed up for 1 year.The local control rate of pancreatic cancer,levels of serum carbohydrate antigen 19-9 and carcinoembryonic antigen,abdominal pain relief rate,jaundice resolution rate,incidence of adverse reactions,and 1-year survival rate were compared between the two groups.Results The local control rate in the observation group reached 85.00%(34/40),which was significantly higher than that in the control group(χ^(2)=5.23,P<0.05).After treatment,the levels of serum carbohydrate antigen 19-9 and carcinoembryonic antigen in the observation group were significantly lower than those in the control group(χ^(2)=2.60,3.97,both P<0.001).The 1-year survival rate in the observation group was 65.00%(26/40),which was significantly higher than that in the control group[42.50%(17/40),χ^(2)=4.07,P<0.05].However,there was no significant difference in incidence of adverse reactions between the two groups(χ^(2)=2.58,0.05,0.39,2.05,all P>0.05).Conclusions Stereotactic body radiotherapy combined with chemotherapy has shown good therapeutic effects in patients with locally advanced pancreatic cancer,without significantly increasing the risk of adverse reactions.Therefore,this combination treatment regimen can be considered an effective option for the treatment of locally advanced pancreatic cancer.

关 键 词：胰腺肿瘤 放射疗法 药物疗法 CA-19-9抗原 癌胚抗原 药物相关性副作用和不良反应 

分 类 号：R73[医药卫生—肿瘤]