中华胰腺病杂志
中華胰腺病雜誌
중화이선병잡지
CHINESE JOURNAL OF PANCREATOLOGY
2013年
5期
311-314
,共4页
胰腺肿瘤%放射疗法%药物疗法%5-氟尿嘧啶%吉西他滨%回顾性研究
胰腺腫瘤%放射療法%藥物療法%5-氟尿嘧啶%吉西他濱%迴顧性研究
이선종류%방사요법%약물요법%5-불뇨밀정%길서타빈%회고성연구
Pancreatic neoplasms%Radiotherapy%Drug therapy%5-FU%Gemcitabine%Retrospective studies
目的 比较放疗联合5-氟尿嘧啶(5-FU)与放疗联合吉西他滨治疗局部晚期胰腺癌的疗效及放、化疗不良反应.方法 回顾性分析第四军医大学西京医院放疗科2007年1月到2011年1月收治的56例局部晚期不可手术切除的胰腺癌患者的资料.入组患者均采用三维适形或三维适形调强放疗并同期给予单药5-FU或吉西他滨化疗.放疗剂量每次1.8 ～2 Gy,每周5次,总剂量45 ～ 50.4 Gy,共25～ 28次.同期吉西他滨化疗组共30例,在放疗期间的第1、8、15、22天以500 mg/m2体表面积的剂量、10 mg· (m2)-1·min-1微量泵泵入给药；放疗结束后休息3周,再以800 mg· (m2)-1·d-1的剂量静脉滴注,每周1次,连用3～4周.同期5-FU化疗组共26例,放疗期间以500 mg· (m2)-1·d-l剂量静脉滴注,每周第1～5天给药,14 d一个周期；放疗结束后休息3周,按照800 mg·(m2)-1·d-1的剂量静脉滴注,每周第1～5天给药,14 d一个周期,连用3～4个周期.观察疗效和不良反应,并对患者进行随访,随访截止日为2013年6月,计算患者中位生存时间和l、2年生存率.结果 全组客观有效率(CR+ PR)为73.2％,放疗联合5-FU组总有效率为65.3％,放疗联合吉西他滨组总有效率80.0％(P＜0.05).全组1、2年生存率分别为48.2％和14.3％,中位生存期为15.2个月,其中放疗联合5-FU组分别为42.3％、11.5％、13.3个月,放疗联合吉西他滨组分别为53.3％、16.7％、16.6个月,两组患者生存率差异无统计学意义(P=0.071).治疗结束后全组疼痛客观缓解率(VAS评分＜4分)为83.3％,放疗联合5-FU组为75％,放疗联合吉西他滨组为90％.放疗联合吉西他滨治疗组发生3～4级骨髓抑制率显著高于放疗联合5-FU组,差异具有统计学意义(20.0％比7.6％,P＜0.05).结论 手术不能切除的局部晚期胰腺癌患者采用放疗联合吉西他滨化疗在长期生存、疼痛缓解方面较放疗联合5-FU具有优势,但骨髓抑制的不良反应较强.
目的 比較放療聯閤5-氟尿嘧啶(5-FU)與放療聯閤吉西他濱治療跼部晚期胰腺癌的療效及放、化療不良反應.方法 迴顧性分析第四軍醫大學西京醫院放療科2007年1月到2011年1月收治的56例跼部晚期不可手術切除的胰腺癌患者的資料.入組患者均採用三維適形或三維適形調彊放療併同期給予單藥5-FU或吉西他濱化療.放療劑量每次1.8 ～2 Gy,每週5次,總劑量45 ～ 50.4 Gy,共25～ 28次.同期吉西他濱化療組共30例,在放療期間的第1、8、15、22天以500 mg/m2體錶麵積的劑量、10 mg· (m2)-1·min-1微量泵泵入給藥；放療結束後休息3週,再以800 mg· (m2)-1·d-1的劑量靜脈滴註,每週1次,連用3～4週.同期5-FU化療組共26例,放療期間以500 mg· (m2)-1·d-l劑量靜脈滴註,每週第1～5天給藥,14 d一箇週期；放療結束後休息3週,按照800 mg·(m2)-1·d-1的劑量靜脈滴註,每週第1～5天給藥,14 d一箇週期,連用3～4箇週期.觀察療效和不良反應,併對患者進行隨訪,隨訪截止日為2013年6月,計算患者中位生存時間和l、2年生存率.結果 全組客觀有效率(CR+ PR)為73.2％,放療聯閤5-FU組總有效率為65.3％,放療聯閤吉西他濱組總有效率80.0％(P＜0.05).全組1、2年生存率分彆為48.2％和14.3％,中位生存期為15.2箇月,其中放療聯閤5-FU組分彆為42.3％、11.5％、13.3箇月,放療聯閤吉西他濱組分彆為53.3％、16.7％、16.6箇月,兩組患者生存率差異無統計學意義(P=0.071).治療結束後全組疼痛客觀緩解率(VAS評分＜4分)為83.3％,放療聯閤5-FU組為75％,放療聯閤吉西他濱組為90％.放療聯閤吉西他濱治療組髮生3～4級骨髓抑製率顯著高于放療聯閤5-FU組,差異具有統計學意義(20.0％比7.6％,P＜0.05).結論 手術不能切除的跼部晚期胰腺癌患者採用放療聯閤吉西他濱化療在長期生存、疼痛緩解方麵較放療聯閤5-FU具有優勢,但骨髓抑製的不良反應較彊.
목적 비교방료연합5-불뇨밀정(5-FU)여방료연합길서타빈치료국부만기이선암적료효급방、화료불량반응.방법 회고성분석제사군의대학서경의원방료과2007년1월도2011년1월수치적56례국부만기불가수술절제적이선암환자적자료.입조환자균채용삼유괄형혹삼유괄형조강방료병동기급여단약5-FU혹길서타빈화료.방료제량매차1.8 ～2 Gy,매주5차,총제량45 ～ 50.4 Gy,공25～ 28차.동기길서타빈화료조공30례,재방료기간적제1、8、15、22천이500 mg/m2체표면적적제량、10 mg· (m2)-1·min-1미량빙빙입급약；방료결속후휴식3주,재이800 mg· (m2)-1·d-1적제량정맥적주,매주1차,련용3～4주.동기5-FU화료조공26례,방료기간이500 mg· (m2)-1·d-l제량정맥적주,매주제1～5천급약,14 d일개주기；방료결속후휴식3주,안조800 mg·(m2)-1·d-1적제량정맥적주,매주제1～5천급약,14 d일개주기,련용3～4개주기.관찰료효화불량반응,병대환자진행수방,수방절지일위2013년6월,계산환자중위생존시간화l、2년생존솔.결과 전조객관유효솔(CR+ PR)위73.2％,방료연합5-FU조총유효솔위65.3％,방료연합길서타빈조총유효솔80.0％(P＜0.05).전조1、2년생존솔분별위48.2％화14.3％,중위생존기위15.2개월,기중방료연합5-FU조분별위42.3％、11.5％、13.3개월,방료연합길서타빈조분별위53.3％、16.7％、16.6개월,량조환자생존솔차이무통계학의의(P=0.071).치료결속후전조동통객관완해솔(VAS평분＜4분)위83.3％,방료연합5-FU조위75％,방료연합길서타빈조위90％.방료연합길서타빈치료조발생3～4급골수억제솔현저고우방료연합5-FU조,차이구유통계학의의(20.0％비7.6％,P＜0.05).결론 수술불능절제적국부만기이선암환자채용방료연합길서타빈화료재장기생존、동통완해방면교방료연합5-FU구유우세,단골수억제적불량반응교강.
Objective To evaluate the efficacy,adverse events of gemcitabine vs.5-FU with radiotherapy for locally advanced pancreatic carcinomas.Methods Between January 2007 and January 2011,a total of 56 patients with locally advanced pancreatic carcinomas was included and clinical data were retrospectively analyzed.All patients received 3-DCRT radiotherapy with individual dose of 1.8 ～ 2 Gy,5 times per week,and total dose of 45 ～ 50.4 Gy for 25 ～ 28 fractions,and received concurrent chemotherapy (5-FU or gemcitabine).The patients (n =30) in gemcitabine group were treated with gemcitabine (500 rng/m2 at the 1st,8th,15th,22nd day,at 10 mg · (m2)-1 · min-1,through micro-pump) during radiotherapy; 3 weeks after radiotherapy the patients received gemcitabine infusion at a dose of 800 mg · (m2)-1 · d-1,one time per week,for 3 or 4 cycles.The patients (n =26) in 5-FU group were treated with 5-FU (500 mg/m2 at the 1 ～ 5th day per week,IV),the cycle was repeated every 2 weeks during radiotherapy; 3 weeks later the patients received 5-FU infusion at a dose of 800 mg · (m2)-1 · d-1,the 1st ～5th day per week,the cycle was repeated every 2 weeks ; with a total of 3 or 4 cycles.The efficacy and adverse events were observed,and the patients were followed until June 2013,and the median survival,1 year and 2 year survival was calculated.Results Of the 56 patients,the overall response (CR + PR) rate was 73.2％,and it was 65.3％ in radiotherapy with 5-FU group,80.0％ in radiotherapy with gemcitabine group (P ＜ 0.05).The overall one and two year survival rate was 48.2％ and 14.3％,while median survival was 15.2 months,and the corresponding values were 42.3％,11.5％,13.3 months in radiotherapy with 5-FU group,and 53.3％,16.7％,16.6 months in radiotherapy with gemcitabine group,and the survival difference between the two groups was not statistically significant (P =0.071).At the end of treatment,the pain-relief rate (VAS score ＜4) of the 56 patients was 83.3％,it was 75.0％ in 5-FU group and 90.0％ in gemcitabine group.In radiotherapy with gemcitabine group,the incidence of 3～ 4 grade myelosuppression was significantly higher than that in radiotherapy with 5-FU group,and the difference between the two groups was statistically significant (20.0％ vs 7.6％,P ＜ 0.05).Conclusions For the locally advanced pancreatic carcinomas,radiotherapy with gemcitabine can improve pain-relief and prolong survival compared with radiotherapy with 5-FU,but the incidence of adverse event of myelosuppression is higher.
