CAJ | 학술논문

目的通过不能手术胰腺癌单纯介入治疗、常规或三维适形放疗、常规或三维适形放疗+介入治疗模式的预后分析,探讨最佳治疗模式.方法回顾分析2003-2008年收治的139例局部晚期(Ⅲ期,82例)和转移性(Ⅳ期,57例)胰腺癌患者资料,其中胰头癌74例.3例患者穿刺病理诊断为导管腺癌,大多为CT、MRI超声等影像学结合临床症状和化验检查临床诊断.单纯介入治疗、常规或三维适形放疗、常规或三维适形放疗+介入治疗分别为71、34、34例,比较3种治疗模式结果并行单因素及Cox模型多因素分析.结果随访率为92.1%,随访满1、2年者分别为115、98例.全组1和2年生存率分别为37.1%和16.3%,局部晚期胰腺癌的分别为44%和20%,单纯介入治疗、常规或三维适形放疗、常规或三维适形放疗+介入治疗的分别为18%和5%、61%和29%、48%和25%(χ2=14.65,P=0.001).全组胰腺癌预后单因素分析有意义因素为分期(χ2=4.49,P=0.035)、是否接受常规或三维适形放疗(χ2=15.32,P=0.000)、肿瘤原发部位(χ2=10.74,P=0.002)等,多因素分析有意义因素为肿瘤原发部位(χ2=5.00,P=0.025)、是否接受常规或三维适形放疗(χ2=7.93,P=0.005).结论对不能手术的局部晚期胰腺癌患者,常规或三维适形放疗是有效的治疗模式,而常规或三维适形+介入治疗效果还需进一步研究.
목적 통과불능수술이선암단순개입치료、상규혹삼유괄형방료、상규혹삼유괄형방료+개입치료모식적예후분석,탐토최가치료모식.방법 회고분석2003-2008년수치적139례국부만기(Ⅲ기,82례)화전이성(Ⅳ기,57례)이선암환자자료,기중이두암74례.3례환자천자병리진단위도관선암,대다위CT、MRI초성등영상학결합림상증상화화험검사림상진단.단순개입치료、상규혹삼유괄형방료、상규혹삼유괄형방료+개입치료분별위71、34、34례,비교3충치료모식결과 병행단인소급Cox모형다인소분석.결과 수방솔위92.1%,수방만1、2년자분별위115、98례.전조1화2년생존솔분별위37.1%화16.3%,국부만기이선암적분별위44%화20%,단순개입치료、상규혹삼유괄형방료、상규혹삼유괄형방료+개입치료적분별위18%화5%、61%화29%、48%화25%(χ2=14.65,P=0.001).전조이선암예후단인소분석유의의인소위분기(χ2=4.49,P=0.035)、시부접수상규혹삼유괄형방료(χ2=15.32,P=0.000)、종류원발부위(χ2=10.74,P=0.002)등,다인소분석유의의인소위종류원발부위(χ2=5.00,P=0.025)、시부접수상규혹삼유괄형방료(χ2=7.93,P=0.005).결론 대불능수술적국부만기이선암환자,상규혹삼유괄형방료시유효적치료모식,이상규혹삼유괄형+개입치료효과환수진일보연구.
Objective To analyze the results and prognosis for patients with inoperable pancreatic carcinoma treated by interventional chemotherapy (IC) ,three-dimensional radiotherapy (RT), or IC + RT.Methods From 2003 to 2008,139 patients with locally advanced (82 patients, stage Ⅲ) or metastatic (57 patients, stage Ⅳ) pancreatic cancer were retrospectively analyzed, including 74 with pancreatic head carcinoma (53.2%).Three patients with ductal adenocarcinoma were diagnosed with fine-needle aspiration, all other patients were clinically diagnosed with imagings (CT, MRI and/or ultrasonosraphy),clinical symptoms and tumor markers, There were 71,34 and 34 patients receiving IC alone, 3DCRT alone and 3DCRT plus IC, respectively.Log-rank univariate and Cox model multivariate analyses were used to determine prognostic factors.Results The follow-up rate was 92.1%.115 and 98 patients were followedup longer than 1 and 2 years, respectively.The 1-and 2-year overall survival rates were 37.1% and 16.3%for all patients, 44% and 20% for patients with locally advanced disease.The corresponding rates were 18% and 5%, 61% and 29% ,48% and 25% (χ2= 14.65,P=0.001) for patients receiving IC alone, RT alone, and IC + RT, respectively.In univariate analysis, staging (χ2= 44.49, P = 0.035), radiotherapy (χ2= 15.32, P = 0.000) and tumor location (χ2= 10.741, P = 0.002) were prognostic factors.In multivariate analysis, tumor location (χ2= 5.00, P = 0.025) and radiotherapy (χ2= 7.93, P = 0.005) were prognostic factors.Conclusions Radiotherapy can improve overall survival among patients with inoperable pancreatic cancer.The effect of RT + IC should be further investigated.