复方苦参注射液联合三维适形调强放疗治疗局部晚期胰腺癌临床观察

Clinical observation of locally advanced pancreatic cancer treated by compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy

目的 研究复方苦参注射液联合三维适形调强放疗治疗局部晚期胰腺癌的近期临床效果.方法 48例局部晚期初治胰腺癌患者分为三维适形调强放疗加复方苦参组（治疗组）和三维适形调强放疗组（对照组）,每组24例.三维适形调强放疗采用95％的等剂量曲线覆盖计划靶区.采用6MVX线照射,2 Gy/次,5次/周,总放疗剂量50 Gy.治疗组治疗前l周给予输注复方苦参注射液20 ml/次,1次/d,21 d为1个周期;对照组单纯行调强放疗.结果 治疗结束后治疗组临床受益反应率为87.5％（21/24）,对照组为70.83％（17/24）,两组比较差异具有统计学意义（P=0.045）.治疗组近期疗效有效率为79.17 ％（19/24）,对照组为50.00％（12/24）,两组比较差异具有统计学意义（P=0.035）.血液毒性不良反应中,治疗组白细胞下降发生率为16.67％（4/24）,对照组为45.83％（11/24）,两组比较差异具有统计学意义（P=0.029）.结论复方苦参注射液联合三维适形调强放疗治疗局部晚期胰腺癌效果较好,可缓解疼痛,提高近期疗效,减轻不良反应,改善患者生活质量.

Objective To study the recent clinical efficacy of compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy in the treatment of locally advanced pancreatic cancer. Methods 48 cases of untreated locally advanced pancreatic cancer were randomly divided into treatment group （compound matrine injections combined with three-dimensional cunformal intensity modulated radiotherapy） and control group （three-dimensional conformal intensity modulated radiationtherapy）, there were 24 cases in each group. Three-dimensional conformal intensity modulated radiation therapy used 95 % isodose coverage PTV. Using 6 MV X-ray irradiation, 2 Gy/day, 5 times/week, the total radiation dose was 50 Gy/25 times/5 weeks to complete. Treatment group： one week before treatment infusion of compound matrine injections 20 ml/time, l/d, 21-day was one cycle. Control group： simple intensity modulated radiotherapy. Results After treatment, the clinical benefit response rate of the treatment group was 87.5 % （21/24）, the control group was 70.83 % （17/24）, the difference was statistically significant （P = 0.045）. Term efficacy rate of the treatment group was 79.17 % （19/24）, the control group was 50.00 % （12/24）, the difference was statistically significant （P = 0.035）. Adverse reactions were hematologic toxicity, leukopenia occurred in the treatment group was 16.67 % （4/24）, but the control group was 45.83 % （11/24）, the difference was statistically significant （P = 0.029）. Conclusion The effects of compound matrine injections combined with three-dimensional conformal intensity modulated radiotherapy for locally advanced pancreatic cancer are good, they can relieve pain, improve short-tem~ efficacy, reduc side effects, and improve the quality of life.