三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌的临床研究

Clinical study of three dimensional-conformal radiotherapy combined with tegafur and cisplatin for locally advanced pancreatic cancer

目的:评价三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌的疗效及毒性。方法:采用同时放化学疗法治疗局部晚期胰腺癌患者19例,放射治疗采用三维适形放射治疗,常规分割,共54～62Gy;化学治疗第1～5天,替加氟800mg/d、顺铂20mg/d,21d为1个周期,共4个周期;化学治疗与放射治疗同时在第1天开始。结果:治疗总有效率36.8%;治疗前后CA199均数分别为425kU/L和79kU/L,差异有统计学意义;中位生存时间为10.9个月,1年生存率42.1%,2年生存率21.1%。结论:三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌疗效与健择等其他同步化学治疗方案疗效相似,毒副反应患者能够耐受,值得进一步研究。

Objective： To evaluate the effect and toxicity of concurrent chemo-radiotherapy consisting of three dimensional-conformal radiotherapy and cisplatin （CDDP）/tegafur（FT-207） infusion in patients with locally advanced pancreatic cancer. Methods; Nineteen patients with locally advanced pancreatic cancer were treated with concurrent chemoradiotherapy. Three dimension al-conformal radiotherapy of 54-62Gy was delivered at the rate of 1.8-2Gy per fraction. Concurrentchemoradiotherapy was given at the first day （Chemotherapy： FT-207 800mg/d and CDDP 20mg/d, 1-5 of 21-day cycle, at least four cycles.） The t-test was performed to compare the level of CA-199 before and after therapy. Overall survival rate was estimated by the Kaplan-Meier method. Results： The overall response rate was 36.8%. The level of CA-199 was 425u/ml before therapy and 79u/ml after therapy （P〈0.02）. The median survival time was 10.9 months. The 1-year survival rate was 42.1% and 2-year survival rate was 21.1 %. Conelusion： Three dimensional-conformal radiotherapy combined with FT-207 and CDDP chemotherapy had similar effect with concurrent gemcitabine （GEM） chemotherapy for the treatment of patients with locally advanced pancreatic cancer.