晚期胰腺癌放射治疗的临床观察及分析

Observation and analysis on intraoperative radiotherapy (IORT) for locally advanced cancer of pancreas

目的探讨不能手术切除的晚期胰腺癌放射治疗的疗效分析。方法2004年2月至2006年3月我科共收治28例不能切除的晚期胰腺癌患者行放射治疗。肿瘤位于胰头者21例,位于胰体及胰尾者7例。Karnofsky评分标准皆在60分以上。采用加速器6~15mV X线体外照射,常规分割(1.8~2.0Gy/次/d)15例,非常规分割(1.2~1.8Gy/次,2~3次/d)13例。放疗剂量<40Gy6例,50~60Gy 8例,6l^70Gy 8例,>70Gy 6例。结果15例患者于放疗1周时症状及体征明显改善;治疗后评价CR7例,占25.0%,PR10例,占35.7%,NC11例,占39.3%,总有效率(CR)为61.7%。结论对不能切除的局部晚期胰腺癌采用放射治疗可有效缓解症状,改善生存质量,适当延长生存期。

Objective To study the effect of intraoperative radiotherapy （IORT） combined with palliative surgical treatment on the locally advanced pancreatic carcinoma. Methods From February 2004 to March 2006, 28 cases were treated patients with advanced pancreatic cancer radiotherapy. Pancreatic cancer in 21 patients in the pancreatic body and tail of pancreas are seven cases. Karnofsky score 60 or more points in all. 6 mV accelerator used to 15 mV X line in vitro exposure to conventional fraction （ 1.8-2. 0 Gy/times/day, n = 15 ） and unconventional segmentation （ 1.2-1.8 Gy/time, 2 or 3 times/day） 13 cases. There is radiotherapy dose 〈 40 Gy 6 cases; 50-60 Gy in 8 cases; 61-70 Gy 8 cases; 〉70 Gy in 6 cases. Results Radiotherapy in 15 patients in 1 week, signs and symptoms improved significantly after treatment evaluation CR7 cases, accounting for 25.0%, PR10 cases, accounting for 35.7%, NCll cases, accounting for 39. 3%, the total efficiency of 61.7% for CR. Conclusion Unreseetable locally advanced pancreatic cancer by radiation therapy can be effective to relieve symptoms and improve quality of life, an appropriate extension of survival.