三维适形放疗同步卡培他滨联合吉西他滨治疗32例局部晚期胰腺癌的临床观察

Observation of capecitabine and gemcitabine combined with concurrent radiotherapy for locally advanced pancreatic carcinoma

目的探讨同步放化疗(CCRT)治疗局部晚期胰腺癌的疗效和毒性反应。方法2003年1月至2006年2月共收治局部晚期胰腺癌患者32例,采用三维适形放疗(3DCRT),总量45～54Gy;同步化疗方案为:卡培他滨1500mg/m2,分2次口服,第1～14天;吉西他滨1000mg/m2,静脉滴注第1、8、15天。21天为1周期,与放疗同时开始,CCRT结束后1个月巩固化疗2～4周期。结果所有患者均完成CCRT治疗,其中21例完成4个周期巩固化疗,7例3个周期,4例2个周期。有效率为56.2%,中位生存期为18.8个月,1、2年生存率分别为46.8%和22.5%;疼痛缓解率65.6%(21/32),生活质量明显改善,无治疗相关性死亡。结论三维适形放疗同步卡培他滨联合吉西他滨治疗局部晚期胰腺癌疗效显著,能提高局部控制率,延长生存期,缓解疼痛,提高生活质量,且毒副反应能够耐受。

Objective To explore the efficacy and toxic reaction of concurrent chemoradiotherapy for locally advanced pancreatic carcinoma patients.Methods From January 2003 to February 2006,32 patients were treated by 3DCRT（45-54 Gy）and concurrent chemotherapy using capecitabine（1500mg/m^2 orally,d1-d14,21 days per cycle） and gemcitabine（1000mg/m^2 iv drop,d1,d8,d15;21 days per cycle）.The concurrent chemotherapy was for 2 circles.After CCRT,2-4 circles of the same program for consolidation chemotherapy were used one month later.Results All of the patients finished the CCRT,in which 21 patients were given consolidation chemotherapy for 4 circles,7 patients were given 3 circles and 4 patients were given 2 circles.The total response rate was 56.2%.The medium overall survival was 18.8 months.The 1-and 2-year survival rates were 46.8% and 22.5%.The pain-alleviation rate was 65.6%.Quality of life was improved without any treatment related death.Conclusion Capecitabine and gemcitabine combined with concurrent radiotherapy for advanced pancreatic carcinoma is effective and well-tolerated in patients with post-operatively local regionally recurrent or advanced pancreatic carcinoma.