摘要
目的观察评价体部γ-刀治疗中晚期胰腺癌的疗效和放射反应。方法对52例Ⅱ~Ⅳ期胰腺癌采用体部γ-刀治疗,治疗时采用体架和真空负压袋固定体位,CT 扫描和三维计划,PTV在 GTV 外扩1cm,50%剂量线为处方剂量线,胰头癌3~4Gy/次,胰体尾癌4~5Gy/次,5次/周,肿瘤边缘总剂量40~51Gy,肿瘤中心区域80~102Gy。结果原发灶的完全缓解率(CR)19.2%,部分缓解率(PR)69.2%,总有效率(CR+PR)88.4%。Ⅱ~Ⅳ期1、2年总生存率分别为56.5%和23.1%。Ⅱ期1、2年生存率分别为76.9%和46.7%;Ⅱ期和Ⅲ~Ⅳ期的2年生存率间的差异有显著性意义。治疗期间胃肠反应 RTOG Ⅰ~Ⅱ级为57.3%,Ⅲ级5%,经对症处理病人均能按计划完成治疗。结论体部γ-刀治疗胰腺癌采用3~5Gy/次,5次/周,肿瘤边缘50%剂量线处总剂量45~51Gy 的治疗模式是安全有效的,对不能手术的局部晚期可提高局控率和生存率。
Objective To evaluate the efficacy of body gamma knife treatment for stage Ⅱ -Ⅳ pancreatic carcinoma (PC) and investigate the reaction of patients to the treatment. Methods From August 2000 to February 2003, 52 patients with stage Ⅱ-Ⅳ PC were treated with the Stereotactic Gamma Ray Whole-body Therapeutic System (body gamma knife) in our hospital. For body gamma knife treatment, a stereotactic body frame for exact tumor localization, reproducible fixation, CT sim- ulation and 3-D treatment plan was developed. The margin of PTV was over 1 cm in GTV, 50% dose line was prescribed dose curve and covered over 95% area of PTV. The patients with pancreatic head carcinoma were irradiated with 3-4 Gy/fraction at 50% dose line. For patients with tumors of the pan- creatic body and tail, the irradiation with 4-5 Gy/fraetion at 50% dose line was performed, 5 d a week and a total dose of 40-51Gy was delivered at the tumor margin. Meanwhile, the total dose of 80-102 Gy was delivered at the tumor central area. Results The complete response rate (CR) and partial response rate (PR) in the primary tumor were 19.2% and 69.2%, respectively, and the overall response rate (CR+PR) was 88. 4% 2-3 months after the treatment. The 1-, 2-year overall survival rates were 56.5% and 23. 1% for patients with tumor of stage Ⅱ-Ⅳ and 76.9% and 46.7% for those with tumor of stage Ⅱ, respectively. Acute gastrointestinal reactions were found in 57.3% for RTOG grade Ⅰ-Ⅱ and 5 % for RTOG grade Ⅲ. The whole process was bearable for all the patients after allopathy. Conclusions This new technique, which is non-invasive and painless, is effective and safe and can improve the local control rate and survival rate for patients with local advanced pancreatic cnrcinoma thnt is not resectable.
出处
《中华肝胆外科杂志》
CAS
CSCD
2006年第2期86-88,共3页
Chinese Journal of Hepatobiliary Surgery
关键词
胰腺肿瘤
Pancreatic neoplasms