术中放疗联合术后同步放化疗治疗局部晚期胰腺癌

Intraoperative radiotherapy combined with postoperative concurrent chemoradiotherapy for locally ad- vanced pancreatic cancer

目的评价术中放疗（IORT）联合术后同步放化疗在局部晚期胰腺癌治疗的价值。方法回顾性分析北京协和医学院中国医学科学院肿瘤医院2008年5月至2011年5月收治的85例局部晚期胰腺癌。治疗组40例（A组）行IORT加内引流联合术后同步放化疗，对照组45例（B组）仅行IORT加内引流的。总结2组的临床资料、术式等，并定期随访，评价2组的生存期等。结果随访6～15个月，随访率90％（77／85）。A组平均生存10．17±0．58个月，B组为8．05±0．48个月；A组中位生存时间11．40个月，B组为8．30个月。生存分析显示A组较B组有明显的生存优势（P=0．027）。A组死亡10例，B组12例，2组比较差异无统计学意义（P=0．805）。结论IORT联合术后同步放化疗可提高局部晚期胰腺癌患者生存率。

Objective To assess the value of intraoperative radiotherapy （IORT） combined with postop- erative concurrent chemoradiotherapy for locally advanced pancreatic cancer. Methods From May 2008 to May 2011, 85 cases of locally advanced pancreatic cancer patients in our hospital were analyzed retrospectively. The treatment group included 40 cases treated by IORT plus drainage combined with postoperative concurrent chemo- radiotherapy （ group A）, and the control group included 45 undergoing IORT plus drainage （ group B）. The clin- ical manifestation, operation plan etc. were summed up and all cases were followed up regularly to evaluate the survival time. Results The follow-up time was from 6 to 15 months and the follow-up rate is 90% （77/85）. For group A and group B, the mean survival time was 10. 17 ±0. 58 months VS 8. 05 ±0. 48 months and the median survival time was 11.40 months VS 8.30 months. The survival analysis showed that group A had a significant sur- vival advantage than group B （P = 0. 027）. 10 patients died in group A and 12 patients died in group B. The difference had no statistical significance （P = 0. 805 ）. Conclusion IORT plus postoperative concurrent chemo- radiotherapy can improve the survival rate of patients with locally advanced pancreatic cancer.