CAJ | 학술논문

目的总结局部进展期胰腺癌术中放疗后早期并发症的发生、治疗和转归情况.方法回顾性分析2008年11月至2012年1月在中国医学科学院肿瘤医院接受术中放疗的115例局部进展期胰腺癌患者的临床资料,其中肿瘤位于胰头部81例,胰体、尾部34例.治疗方式为术中放疗联合内引流手术.术中放疗采用Mobetron移动式术中电子线加速器,剂量为12～ 20 Gy.结果 115例患者的术后早期并发症包括胃瘫12例(10.4％),出血4例(3.5％),胆瘘1例(0.9％),胰瘘1例(0.9％),腹腔感染3例(2.6％),肾功能不全2例(1.7％).除1例患者因消化道出血死亡外,其余患者的并发症经治疗后均获得痊愈.结论采用术中放疗治疗局部进展期胰腺癌的主要早期并发症为胃瘫、出血和腹腔感染等,其中胃瘫的发生率最高.术后早期并发症的治疗效果较好,术中放疗是安全、可靠的治疗方法.
목적 총결국부진전기이선암술중방료후조기병발증적발생、치료화전귀정황.방법 회고성분석2008년11월지2012년1월재중국의학과학원종류의원접수술중방료적115례국부진전기이선암환자적림상자료,기중종류위우이두부81례,이체、미부34례.치료방식위술중방료연합내인류수술.술중방료채용Mobetron이동식술중전자선가속기,제량위12～ 20 Gy.결과 115례환자적술후조기병발증포괄위탄12례(10.4％),출혈4례(3.5％),담루1례(0.9％),이루1례(0.9％),복강감염3례(2.6％),신공능불전2례(1.7％).제1례환자인소화도출혈사망외,기여환자적병발증경치료후균획득전유.결론 채용술중방료치료국부진전기이선암적주요조기병발증위위탄、출혈화복강감염등,기중위탄적발생솔최고.술후조기병발증적치료효과교호,술중방료시안전、가고적치료방법.
Objective To investigate the complications in intra-operative radiotherapy (IORT) for patients with local advanced pancreatic cancer.Methods The clinical data,operation material,overall dose of IORT,postoperative therapy,complications,treatment and prognosis were retrospectively analyzed in all the in-hospital pancreatic cancer patients from Nov 2008 to Jan 2012.Results There were 115 patients with local advanced pancreatic cancer treated with IORT in this study.81 cases had a tumor in the head of pancreas and 34 cases in the pancreatic body and tail.The operation method was IORT combined with internal drainage surgery.The intra-operative radiotherapy was performed using Mobetron mobile electron accelerator,with a total dose of 12-20 Gy.Bilioenteric anastomosis and/or gastrointestinal anastomosis were included in the internal drainage surgery.Gastroparesis syndrome (10.4％),hemorrhage (3.5％),abdominal infection (2.6％),pancreatic fistula (0.9％) and renal failure (1.7％) were the common postoperative complication of IORT.All patients were cured except one who died of digestive tract hemorrhage.Conclusions Major complications of IORT are gastroparesis syndrome,abdominal infection and hemorrhage.The incidence of gastroparesis syndrome is at the top of the list.However,early complications have a relatively better prognosis,indicating that IORT is a safe and reliable therapy for patients with locally advanced pancreatic cancer.