肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2014年
9期
617-619,623
,共4页
朱奇%康静波%聂青%吴苏冬%李启亮
硃奇%康靜波%聶青%吳囌鼕%李啟亮
주기%강정파%섭청%오소동%리계량
胰腺肿瘤%替吉奥%体部伽玛刀%治疗
胰腺腫瘤%替吉奧%體部伽瑪刀%治療
이선종류%체길오%체부가마도%치료
Pancreatic neoplasms%S-1%γ-ray stereotactic body radiation therapy%Therapy
目的 观察替吉奥联合体部伽玛刀对局部晚期胰腺癌患者的治疗效果及安全性.方法 45例局部晚期胰腺癌患者被随机分为两组,联合组23例患者采用体部伽玛刀治疗,计划靶体积(PTV)覆盖95％以上临床靶体积(CTV),等剂量曲线为50％～60％.肿瘤直径≤5 cm的单次周边剂量3.6～4.5 Gy,肿瘤直径＞5 cm的单次周边剂量3.0～4.0 Gy,治疗9～ 12次,同时口服替吉奥40 mg/m2,2次/d,连续口服21 d,28 d为1个周期,口服4个周期.对照组22例患者单纯接受体部伽玛刀治疗.评价治疗效果及不良反应.结果 两组完全缓解率分别30.4％(7/23)和13.6％(3/22),有效率分别为91.3％(21/23)和63.6％(14/22),差异具有统计学意义(x2=4.980,P=0.026).两组胃肠道反应发生率分别为82.6％和68.2％(x2=1.267,P=0.260);骨髓抑制发生率分别为78.3％和63.6％(x2=1.171,P=0.279),联合组Ⅲ～Ⅳ级骨髓抑制的发生率高于对照组(x2=4.874,P=0.027).两组中位无进展生存期分别为8个月和6个月(x2=1.357,P＞0.05);中位总生存期分别为17个月和14个月(x2=1.017,P＞ 0.05);1年生存率分别为60.9％和54.5％(x2=0.184,P＞ 0.05).结论 口服替吉奥配合体部伽玛刀治疗胰腺癌可提高患者局部控制率和有效率,且不良反应的耐受性良好,可作为局部晚期胰腺癌同步放化疗安全、有效的选择.
目的 觀察替吉奧聯閤體部伽瑪刀對跼部晚期胰腺癌患者的治療效果及安全性.方法 45例跼部晚期胰腺癌患者被隨機分為兩組,聯閤組23例患者採用體部伽瑪刀治療,計劃靶體積(PTV)覆蓋95％以上臨床靶體積(CTV),等劑量麯線為50％～60％.腫瘤直徑≤5 cm的單次週邊劑量3.6～4.5 Gy,腫瘤直徑＞5 cm的單次週邊劑量3.0～4.0 Gy,治療9～ 12次,同時口服替吉奧40 mg/m2,2次/d,連續口服21 d,28 d為1箇週期,口服4箇週期.對照組22例患者單純接受體部伽瑪刀治療.評價治療效果及不良反應.結果 兩組完全緩解率分彆30.4％(7/23)和13.6％(3/22),有效率分彆為91.3％(21/23)和63.6％(14/22),差異具有統計學意義(x2=4.980,P=0.026).兩組胃腸道反應髮生率分彆為82.6％和68.2％(x2=1.267,P=0.260);骨髓抑製髮生率分彆為78.3％和63.6％(x2=1.171,P=0.279),聯閤組Ⅲ～Ⅳ級骨髓抑製的髮生率高于對照組(x2=4.874,P=0.027).兩組中位無進展生存期分彆為8箇月和6箇月(x2=1.357,P＞0.05);中位總生存期分彆為17箇月和14箇月(x2=1.017,P＞ 0.05);1年生存率分彆為60.9％和54.5％(x2=0.184,P＞ 0.05).結論 口服替吉奧配閤體部伽瑪刀治療胰腺癌可提高患者跼部控製率和有效率,且不良反應的耐受性良好,可作為跼部晚期胰腺癌同步放化療安全、有效的選擇.
목적 관찰체길오연합체부가마도대국부만기이선암환자적치료효과급안전성.방법 45례국부만기이선암환자피수궤분위량조,연합조23례환자채용체부가마도치료,계화파체적(PTV)복개95％이상림상파체적(CTV),등제량곡선위50％～60％.종류직경≤5 cm적단차주변제량3.6～4.5 Gy,종류직경＞5 cm적단차주변제량3.0～4.0 Gy,치료9～ 12차,동시구복체길오40 mg/m2,2차/d,련속구복21 d,28 d위1개주기,구복4개주기.대조조22례환자단순접수체부가마도치료.평개치료효과급불량반응.결과 량조완전완해솔분별30.4％(7/23)화13.6％(3/22),유효솔분별위91.3％(21/23)화63.6％(14/22),차이구유통계학의의(x2=4.980,P=0.026).량조위장도반응발생솔분별위82.6％화68.2％(x2=1.267,P=0.260);골수억제발생솔분별위78.3％화63.6％(x2=1.171,P=0.279),연합조Ⅲ～Ⅳ급골수억제적발생솔고우대조조(x2=4.874,P=0.027).량조중위무진전생존기분별위8개월화6개월(x2=1.357,P＞0.05);중위총생존기분별위17개월화14개월(x2=1.017,P＞ 0.05);1년생존솔분별위60.9％화54.5％(x2=0.184,P＞ 0.05).결론 구복체길오배합체부가마도치료이선암가제고환자국부공제솔화유효솔,차불량반응적내수성량호,가작위국부만기이선암동보방화료안전、유효적선택.
Objective To evaluate the clinical toxicity and efficacy of S-1 combined with γ-ray body stereotactic radiation therapy in treatment of locally advanced pancreatic cancer.Methods Forty-five patients with locally advanced pancreatic cancer were randomly divided into two groups.The combination group received γ-ray stereotactic body radiation therapy which was given isodose curve of 50 ％-60 ％,tumor encircling dose of 3.0-4.5 Gy per fraction depended on dimension of tumors,9-12 fractions.Combined with S-1 40 mg/m2,2 times/d,for consecutive twenty-one days for four courses.The control group was given γ-ray stereotactic body radiation therapy only.Toxicities and effects were evaluated according to the criteria of WHO and RTOG.Results The CR rates in combination group and control group were 30.4 ％ (7/23) and 13.6 ％ (3/22),the response rates were 91.3 ％ (21/23) and 63.6 ％ (14/22) (x2 =4.980,P =0.026).The rates of gastrointestinal tract side reaction in combination group and control group were 82.6 ％ and 68.2 ％ (x2 =1.267,P =0.260),myelosuppression in combination group and control group were 78.3 ％ and 63.6 ％ (x2 =1.171,P =0.279).The rate of Ⅲ-Ⅳ grade myelosuppression in combination group were higher than that in control group (x2 =4.874,P =0.027).The median progression-free survival (PFS) rates of two groups were 8 months and 6 months respectively (x2 =1.357,P ＞ 0.05),the median survival period were 17 months and 14 months (x2 =1.017,P ＞ 0.05),1 year survival rates were 60.9 ％ and 54.5 ％ respectively (x2 =0.184,P ＞ 0.05).Conclusions S-1 combined with body gamma system treatment can improve local control rate and effective rate for inoperable patients with local advanced pancreatic carcinoma,and the adverse reactions are well tolerated.This method can be used as locally advanced pancreatic cancer chemoradiation safe and effective choice.
