体部γ-刀治疗不能手术的胰腺癌28例疗效分析

Body Gama Knief Radiotherapy for 28 Patients with Unresectable Pancreatic Cancer

目的 探讨体部γ 刀对不能手术的晚期胰腺癌的治疗可能性和治疗效果。方法 1998年 9月至 2 0 0 0年 10月 ,采用体部γ 刀治疗不能手术的胰腺癌 2 8例。根据包绕计划靶区的等剂量曲线 (60 %～ 80 %的等剂量曲线 )确定治疗剂量 ,4～ 8Gy/次 ,隔日 1次 ,治疗 5～ 11次 ,使计划靶区边缘剂量达 40～ 44Gy。 结果 治疗结束 8～ 10周后评价近期疗效 ,完全缓解 (CR )率为42 .9% ,部分缓解 (PR)率为 5 3 .5 % ,无变化 (NC )率为 3 .6%。总有效 (CR +PR )率达 96.4%。 1年累计局部控制率为 76.9% ,1年累计生存率达 78.6%。不良反应主要为恶心和食欲下降 ,患者均能耐受。结论 体部γ 刀治疗胰腺癌近期疗效满意 ,不良反应轻 ,为不能手术的晚期胰腺癌患者提供了 1种有效的治疗手段。

Objective To explore the possibility of Body Gama Knief radiotherapy for unresectable pancreatic cancer.Methods From September 1998 to October 2000,28 patients with unresectable adenocarcinoma of the pancreas(11 with Stage Ⅱ and 17 with Stage Ⅲ) were treated with Body Gama Knief.The total radiation dose was 40～44 Gy, 4.0～8.0 Gy per fraction(60%～ 80% isodose line),5～11 fractions,qod.Results The complete response(CR) rate,partial response(PR) rate and no change(NC) rate was 42.9%,53.5% and 3.6%,respectively.The overall response(CR+PR) rate was 96.4%.The 1-year local control rate and 1-year survival rate was 76.9% and 78.6%,respectively.The acute radiation reactions mostly were nausea and inappetence,and were tolerable.Conclusion The Body Gama Knief radiotherapy is a safe and effective treatment for patients with unresectable pancreatic cancer.The better local control rate and long-term survival rate can be expected.