陀螺旋转式^(60)Co放射治疗在进展期胰腺癌中的临床疗效

Clinical value of gyro rotary ^(60)Co radiation for advanced pancreatic cancer

目的比较陀螺旋转式^(60)Co放射治疗联合化疗和单纯化疗在进展期胰腺癌中的临床疗效。方法自2012年1月至2014年1月,前瞻性纳入进展期胰腺癌患者100例,根据完全随机数字表原则将患者分为实验组(n=50)和对照组(n=50),实验组采用陀螺旋转式^(60)Co放射治疗联合化疗,对照组采用单纯化疗。比较两组临床预后和治疗相关并发症。结果与对照组比较,实验组治疗6个月后部分缓解率显著增高(50%vs30%,P=0.041),病情进展率显著降低(22%vs 42%,P=0.032),健康相关的生存质量显著增高(65.87±9.90 vs59.03±10.32,P=0.017);实验组24个月病死率显著降低(46%vs 70%,P=0.015),无进展生存期显著延长(P=0.047)。实验组^(60)Co放射治疗后,1级早期放射性损伤28例,2级5例,3级1例,4级1例。结论陀螺旋转式^(60)Co放射治疗联合化疗显著改善进展期胰腺癌患者临床预后。

Objective To compare the clinical values of gyro rotary 60Co radiation combined with chemotherapy and chemotherapy alone for advanced pancreatic cancer. Methods From Jan. 2012 to Jan. 2014, 100 patients with advanced pancreatic cancer admitted to our hospital were enrolled in this prospective study. According to the principle of complete random digital table, all patients were signed into experiment group（n=50） or control group（n=50）. Patients in experiment group received gyro rotary 60Co radiation combined with chemotherapy while patients in control group received chemotherapy alone. The clinical outcomes and therapy associated complications were compared.Results Compared with patients in control group, patients in experiment group got a significantly higher rate of partial remission（50% vs 30%, P=0.041） after 6 months; with significantly lower rate of disease progression（22% vs42%, P=0.032） after 6 months; decreased tendency in 24-months mortality（46% vs 70%, P=0.015）, longer progressionfree survival duration（P=0.047）; and significantly higher level of health-related quality of life（65.87±9.90 vs59.03±10.32, P=0.017）. After gyro rotary 60Co radiation, 28 patients in the experiment group developed class 1 of early radiation injury, 5 patients with class 2, 1 patient with class 3, 1 patients with class 4. Conclusion Gyro rotary 60Co radiation combined with chemotherapy can improve the clinical outcome of patients with advanced pancreatic cancer.