胰腺癌同步放化疗后放射性胃、十二指肠溃疡发生的临床研究

Radiotherapy induced gastroduodenal ulcer after concurrent chemoradiotherapy in pancreatic cancer

目的描述胰腺癌放疗致放射性胃、十二指肠损伤的内镜下表现,研究放疗同步S-1(替吉奥胶囊)、吉西他滨化疗对放射性溃疡发生的影响。方法对空军总医院2010年2月-2015年5月胰腺癌单纯放疗及放疗同步替吉奥、吉西他滨化疗患者的放疗前、后上消化道内镜下表现进行自身对比研究。以Pearsonχ2检验分析单纯放疗组与放化同步组的放射性溃疡发生率差异有无统计学意义。结果单纯放疗组、放疗同步替吉奥化疗组、放疗同步吉西他滨化疗组放射性溃疡发生率分别为44.1%(26/59)、50.0%(10/20)和46.7%(7/15);3组间放射性溃疡发生率差异无统计学意义(P=0.897)。结论从胰腺癌放化同步对胃、十二指肠安全的角度考虑,患者可根据自身情况同步应用替吉奥、吉西他滨化疗,同步化疗与否对放射性溃疡的发生影响差异无统计学意义。

Objective To describe the endoscopic observation of pancreatic cancer radiotherapy induced gastroduodenal radioactive injury, and investigate the influence of radiation-induced ulceration by concurrent chemoradiotherapy with S-1（Tegafur Gimeracil Oteracil Potassium Capsule） and gemcitabine. Methods Self-comparative study of endoscopic performance were performed on patients received endoscopy before and after pancreatic cancer Chemoradiotherapy with S-1 or gemcitabine or radiotherapy only, from February 2010 to May 2015. Pearson chi-square test was used to analyze whether Concurrent Chemoradiotherapy groups and radiotherapy group are different in radiation-induced ulceration occurrence rate. Results The incidence of radiation-induced ulceration of radiotherapy group, S-1 group and gemcitabine group are 44.1 %（26/59）, 50.0 %（10/20） and 46.7 %（7/15）, respectively.Radiation-induced ulceration incidence was no statistical difference among the three groups. Conclusion From the angle of safety, patients can according to their self-condition for choosing S-1 or gemcitabine chemotherapy. Wether the concurrent chemoradiotherapy treatment was adopted or not, the occurrence rate of radiation-induced ulceration has no significant difference.