同步放化疗对胰腺癌患者胰腺外分泌功能的影响

Impact of concurrent radiochemotherapy on pancreatic exocrine function in patients with pancreatic carcinoma

目的探讨同步放化疗对胰腺癌患者胰腺外分泌功能的影响。方法 15例胰腺癌患者行单纯吉西他滨化疗,14例胰腺癌患者加行同步放疗(照射剂量5-50Gy)。ELISA检测两组治疗前及治疗后6个月内粪便中弹力蛋白酶1(FE1)水平;分析放疗后FE1水平与照射剂量参数的相关性。结果单纯化疗组治疗前后FE1水平相仿(P>0.05);同步放化疗组治疗后FE1水平稍有降低(P>0.05)。同步放化疗组中,与FE1水平未降患者(8例)比较,FE1水平降低患者(6例)的平均剂量(Dmean)较大[(2498.9±822.0)cGy vs.(1927.8±632.3)cGy],照射剂量为35Gy时的正常胰腺组织体积百分比(V35)较小[(27.3±17.0)%vs.(36.6±8.8)%](P<0.05);且FE1水平与V35密切相关(R2=0.347,P<0.05)。结论以吉西他滨为基础的同步放化疗对胰腺癌患者的胰腺外分泌功能没有明显影响。

Objective To explore the impact of concurrent radiochemotherapy on pancreatic exocrine function in the patients with pancreatic carcinoma（PC）. Methods Fifteen PC patients were treated with gemcitabine alone （group A） and fourteen with concurrent radiotherapy （5-50 Gy, group B）. Fecal elastase 1 （FE1） before and in 6 months after treatment was detected by ELISA. The correlation between FE1 level and dose parameteres in group B were analyzed. Results FE1 levels before and after treatment in group A were similar（P〉0. 05）, which were slightly decreased after treatment（P〉0. 05）. The mean dose（Dmean） was morel-（2498.9±822.0） cGy vs. （1927.8±632. 3） cGy]（P〈0. 05） and the percentage of normal pancreatic tissues at exposure dose of 35 Gy（V3s ） was less in 8 patients without decrease of FE1 than that in 6 cases with decrease of FE1 in group B[-（27. 3 ±17.0）% vs. （36.6±8.8）%]（P〈0. 05）. The FE1 level was closely correlated to Va5 （R2 =0. 347, P〈0. 05）. Conclusion Concurrent use of gemcitabine radiochemotherapy has no signifcant effect on pancreatic exocrine function in the patients with PC.