探讨三维适行放射治疗在晚期胰腺癌中的临床意义

Clinical significance of three-dimensional conformal technique treatment for locally advanced pancreatic cancer

目的探讨三维适形放射治疗对局部晚期胰腺癌的疗效。方法将26例局部晚期胰腺癌患者随机分成治疗组13例,对照组13例。治疗组使用三维适形放射治疗,单次肿瘤剂量2-4 Gy,总剂量可达50-54 Gy。单次剂量2-2.5 Gy时一周5次;单次剂量3.5-4 Gy时一周3次。对照组使用常规放射治疗。两组总剂量及分割剂量相同,分割剂量2 Gy。结果治疗组和对照组放射治疗后1个月疼痛缓解分别为11例和7例(χ2=11.56,P<0.01);体重增加分别为10例和7例(χ2=6.12,P<0.05);Karnofsky评分上升分别为8例和5例(χ2=5.54,P<0.05)。治疗组和对照组病灶缓解情况分别为84.6%和53.8%(χ2=7.04,P<0.01),毒副反应率分别为15.4%和46.2%(χ2=6.48,P<0.05),1年生存率分别为61.5%和38.5%(χ2=5.54,P<0.05)。结论三维适形放射治疗局部晚期胰腺癌,能提高患者的生存质量,延长生存期。

Objective To investigate the efficacy of three-dimensional conformal radiation therapy for locally advanced pancreatic cancer.Methods 26 patients with locally advanced pancreatic cancer were randomly divided into treatment group 13 cases,13 cases in the control group.The paitents of treatment group were used the three-dimensional conformal radiation therapy,a single tumor dose of 2-4 Gy,total dose up to 50~54 Gy.2~2.5 Gy single dose,five times a week;3.5~4 Gy single dose,three times a week.The paitents of control group were used conventional radiation therapy.There was the same the total dose and split dose in two groups,split dose 2 Gy.Results There were different in a pain response rate respectively 11 cases and 7 cases（χ2 = 11.56,P 0.01）,weight gain respectively 10 cases and 7 cases（χ2 = 6.12,P 0.05）,increase in Karnofsky performance score respectively 8 cases and 5 cases（χ2 = 5.54,P 0.05）,lesions to defuse the situation respectively 84.6% and 53.8%（χ2 =7.04,P 0.01）,toxicity respectively 15.4% and 46.2%（χ2 = 6.48,P 0.05） and 1 year survival rate respectively 61.5% and 38.5%（χ2 = 5.54,P 0.05） after radiotherapy in treatment and control groups.Conclusion Three-dimensional conformal radiation therapy can improve patient quality of life and prolong survival in locally advanced pancreatic cancer.