中晚期胰腺癌动脉灌注化疗并同期放疗的疗效观察

Arterial infusion chemotherapy combined with concurrent radiotherapy for local advanced pancreatic cancer

目的 分析中晚期胰腺癌动脉灌注化疗并同期放疗与单纯放疗的疗效。方法 对１９９２ 年１ 月至１９９５ 年１０ 月行动脉灌注化疗并同期放疗（ 综合组） 的２２ 例和单纯放疗（ 单放组） 的２８例中晚期胰腺癌的疗效进行比较分析，两组临床资料具可比性。单放组每周照５ 次，每次ＤＴ１－８ ～２－０Ｇｙ，总量５０～６０ Ｇｙ５～６－７ 周；综合组动脉灌注化疗，每次５Ｆｕ１．０ ｇ、ＭＭＣ１０ ｍｇ、ＤＤＰ６０ ｍｇ，每４ 周一次，平均２－３ 次人，同期放疗方案同单放组。结果 腹痛、黄疸的症状缓解率两组之间差异无显著性，但单纯放疗组黄疸改善时间较短（Ｐ＜ ０－０５） ；有效率（ＣＲ＋ ＰＲ）综合组为６８－２％ ，单放组为３５－７％ ；１ ，２，３ 年生存率综合组和单放组分别为７５－３ ％ 、３６－８％ 、２５－４％ 和５１－３％ 、２２－６％ 、８－７ ％ ，综合组明显好于单放组。结论 对不能手术切除的中晚期胰腺癌。

Objective To analyze the treatment results of un resectable local pancreatic cancer by arterial infusion chemotherapy plus concurrent radiotherapy or radiotherapy alone.Methods A total of 50 patients with local advanced pancreatic cancer from January 1992 through October 1995 were treated either by arterial infusion chemotherapy (C) plus concurrent radiotherapy (R) (22 cases) or by radiotherapy alone (28 cases). Radiation given was the same in the two groups of patients (50～60 Gy in 5 to 6 weeks, 1.8～2 Gy/Fx,5 Fx/wk). Infusion chemotherapy was performed once every 4 weeks, consisting of 5 fluorouracil 1.0 g, mitomycin C 10 mg, cisplatin 60 mg. An average of 2.3 cycles was given to each patient.Results Although the remission rate of jaundice and pain did not show significant difference between the two groups, patients in C+R treatment group had longer period of symptomatic remission ( P <0.05). The response rate (CR+PR) was 68.2% in C+R treatment group and 35.7% in R treatment group, respectively. The 1 , 2 , and 3 year survival rate was 75.3%, 36.8%, 25.4% in C+R treatment group, and 51.3%, 22.6%, 8.7% in R treatment group, respectively.Conclusion Arterial infusion chemotherapy combined with concurrent radiotherapy is a treatment of choice for patients with local unresectable cancer of the pancreas.