三维适型放疗或联合卡培他滨在局部晚期胰腺癌中的疗效比较

Effect of Three-dimensional Conformal Radiotherapy combined with or without Capitabine in Advanced Pancreatic Adenocarcinoma

目的评价三维适型放疗单独或联合卡培他滨在晚期胰腺癌中的疗效和耐受性。方法回顾性分析了43例失去手术机会的局部晚期的胰腺癌患者,采用三维适型放疗或口服卡培他滨联合同步放疗的不同疗效。利用上腹部MRI扫描评价肿瘤有效率;Kaplan-Meier曲线比较两组的生存时间。结果完成放疗及联合治疗后2个月随访,联合治疗组客观缓解率(CR+PR)为38.1%,疾病控制率(RR)为85.7%,其中完全缓解0例,部分缓解8例;稳定10例;无效0例。1年随访期内有12例死亡。中位PFS为7.4个月,中位OS为9.9个月。无Ⅳ度毒性发生。3例Ⅲ度手足综合征发生。单纯放疗组客观缓解率(CR+PR)为27.6%,疾病控制率(RR)为63.6%,其中完全缓解0例,部分缓解6例;稳定8例;无效0例。1年随访期内有15例死亡。中位PFS为5.9个月,中位OS为9.0个月。无Ⅳ度毒性发生。结论三维适型放疗联合卡培他滨口服在局部晚期胰腺癌中在延长患者无进展生存期总生存和方面较单纯放疗疗效更好;疾病的短期疗效方面客观缓解率和疾病控制率联合组都有优于单纯放疗组;两种方案对局部晚期胰腺癌患者都是安全有效的,但联合治疗组手足综合征及血液学毒性要重于单药组。

Objective To observe the different effects and tolerance of three dimensional-conformal radiotherapy combined with or without capitabine in advanced pancreatic adenocarcinoma. Methods Data of 43 patients with advanced pancreatic adenocarcinoma who were treated with three dimensionalconformal radiotherapy combined with or without capitabine were respectively analyzed. Tumor response was evaluated by MRI scan 2 months after therapy. Survival analysis was evaluated by kaplan-meier method. Results The tumor responses in combined group were： complete response for 0 patient, partial response for 8 patients, and stable disease for 10 patients after 2 months of treatment. The response rate was 38.1% and the disease control rate was 85.7%. Median progression free survival was 7.4 mo, and median overall survival was 9.9 mo. No grade 4 toxic events were observed. 3 cases Grade 3 hand-food syndrome occurred. The tumor responses in radiotherapy group were： complete response for 0 patients, partial response for 6 patients, and stable disease for 8 patients after 2 months of treatment. The response rate was 27.6% and the disease control rate was 63.6%. Median progression free survival was 5.9 mo, and median overall survival was 9.0 mo. No grade 4 toxic events were observed. Conclusion Three dimensional-conformal radiotherapy combined with or without capitabine also showed promising efficacy in advanced pancreatic adenocarcinoma. Combined treatment could prolong the PFS and OS vs. single dimensional-conformal radiotherapy. And for disease control combined group showed superiority vs. single radiotherapy and the two regimes both showed good safety.