立体定向放疗联合化疗治疗局部晚期肝门胆管癌疗效观察

Effect of stereotactic radiotherapy combined with chemotherapy on locally advanced hilar cholangiocarcinoma

目的探讨立体定向放疗联合化疗治疗无法手术切除的局部晚期肝门胆管癌的临床效果。方法回顾性分析2011年1月-2014年12月我院收治的30例无法切除、局部晚期肝门胆管癌患者的临床资料。对30例患者实施立体定向放射治疗,处方剂量36~48 Gy,3~4 Gy/次,共12~14次;同时从接受立体定向放疗第1天开始,给予患者吉西他滨单药化疗,剂量为1000 mg/m^2,静脉滴注30 min,第1天、第8天给药,每3周1个疗程,共4周期。结果3个月复查时,18例完全缓解,8例部分缓解,4例疾病稳定;6个月复查时,16例完全缓解,7例部分缓解,6例疾病稳定,1例疾病进展。治疗期间毒性反应轻微,均≤2级。中位无进展生存期18个月,中位生存时间24个月,1年和2年生存率分别为70%、50%。结论立体定向放射治疗联合化疗治疗无法切除、局部晚期肝门胆管癌有一定的疗效,耐受性好。

Objective To investigate the clinical effect of stereotactic radiotherapy combined with chemotherapy in the treatment of unresectable and locally advanced hilar cholangiocarcinoma.Methods Clinical data about 30 cases with unresectable and locally advanced hilar cholangiocarcinoma admitted to our hospital from January 2011 to December 2014 were retrospectively analyzed.All patients were treated with stereotactic radiotherapy with a prescription dose of 36-48 Gy,3-4 Gy per-fraction,for a total of 12-14 times.From the first day that all patients received stereotactic body radiotherapy,gemcitabine was given as a single drug chemotherapy,at dose of 1000 mg/m^2 by intravenous infusion for 30min.The drug was given on day 1 and day 8,with every three weeks being a cycle,and a total of 4 cycles.The patients were followed up until December 2016.Results At the 3-month follow-up,18 patients had complete remission 8 cases had partial remission and 4 cases had stable disease.At the 6-month follow-up,complete remission was achieved in 16 cases,partial remission in 7 cases,disease stability in 6 cases and disease progression in 1 case.During the treatment,the toxic reactions were mild,and no serious adverse reaction(>grade 2)occurred.The median time of progression free survival was 18 months,the median survival time was 24 months,and the 1-year and 2-year survival rates were 70%and 50%,respectively.Conclusion Stereotactic radiotherapy combined with chemotherapy shows a considerable anti-cancer effect on unresectable and locally advanced hilar cholangiocarcinoma with mild toxity.