胰腺癌根治术与术后辅助外放疗的疗效比较

Postoperative adjuvant radiotherapy for pancreatic carcinoma patients after radical resection

目的探讨术后放疗对胰腺癌患者生存率的影响。方法44例胰腺癌患者分为手术组（根治性外科切除）和手术＋放疗组（根治性外科切除后接受外放疗），比较两组患者的治疗效果。结果手术组平均生存期为453 d，中位生存期为379 d。手术＋放疗组平均生存期789d，中位生存期为665d。手术组和手术＋放疗组的1、3、5年生存率分别为46．3％、8．3％、4．2％和65．2％、20．2％、14．1％，手术＋放疗组优于手术组（P=0．017）。手术＋放疗组局部复发率及区域淋巴结转移率低于手术组（P〈0．05），且并发症发生率并不高于手术组（P〉0．05）。结论胰腺癌根治术后结合放疗有助于改善患者生存期。

Objective To retrospectively investigate the difference in survival of pancreatic adenocarcinoma patients treated by radical surgery with or without adjuvant radiation therapy. Methods Fortyfour patients with pancreatic cancer underwent surgical resection with a curative intent, and were divided into two groups ： surgery alone （ n = 24 ） or surgery combined with postoperative external beam radiotherapy （EBRT） （ n = 20）. Survival as an endpoint was analyzed between the two groups. Results All 44 patients completed their scheduled treatment. The median survival time of the patients treated with radical resection alone was 379 days versus 665 days for those treated with combined therapy. The 1-, 3-, 5-year survival rates of the patients treated with radical resection alone were 46.3%, 8.3%, 4.2% versus 65.2% , 20.2%, 14.1% for the patients treated with combined therapy, respectively, with a significant difference between the two groups （P =0.017 ）. The failures in local-regional relapse were significantly lower in the postoperative EBRT group than that in the surgery alone group （ P 〈 0. 05 ）, while the additional postoperative radiation therapy did not increase the complication rate （P 〉 0. 05 ）. Conclusion Postoperative external beam radiation therapy can improve the survival in patients with pancreatic ad