立体定向放射治疗联合吉西他滨对局部晚期胰腺癌的疗效观察

Efficacy of stereotactic radiotherapy combined with gemcitabine in the treatment of locally advanced pancreatic cancer

目的探讨立体定向放射治疗联合盐酸吉西他滨治疗局部晚期胰腺癌患者的疗效及预后。方法选取2012年5月至2016年5月间长沙市中心医院收治的无法手术切除的76例局部晚期胰腺癌患者,按照治疗方式不同将患者分为观察组与对照组,每组38例。观察组患者采用立体定向放射治疗联合盐酸吉西他滨治疗,对照组患者采用盐酸吉西他滨治疗。观察两组患者近期治疗疗效、远期治疗疗效及不良反应情况。结果观察组患者总有效率为78.9%,明显高于对照组患者的36.8%,差异有统计学意义(P<0.05)。观察组患者第1年和第2年复发率分别为10.5%和26.3%,均明显低于对照组患者的31.6%和47.4%,第1年和第2年生存率分别为76.3%和50.0%,均明显高于对照组的55.3%和26.3%,两组比较,差异均有统计学意义(均P<0.05)。两组患者治疗期间主要不良反应比较,差异均无统计学意义(均P>0.05)。结论立体定向放射治疗联合盐酸吉西他滨对局部晚期胰腺癌患者相对安全有效,能较好控制患者病情,提高患者生存时间。

Objective To investigate the efficacy and prognosis of stereotactic radiotherapy com- bined with gemcitabine hydrochloride in the treatment of locally advanced pancreatic cancer. Methods The clinical data of 76 patients with unresectable locally advanced pancreatic cancer treated at Changsha Central Hospital from May 2012 to May 2016 were retrospectively analyzed. Patients were divided into an observa- tion group and a control group according to treatment strategy with 38 patients in each group. Patients in the observation group were treated with stereotactic radiotherapy combined with gemcitabine and patients in the control group were treated with signle gemcitabine. The short-term curative effectiveness and long-term treat- ment efficacy and adverse reactions were observed and compared between the two groups. Results The o- verall efficiency in the observation group （78.9%） was significantly higher than in the control group （36. 8% ） （P 〈0.05）. The recurrence rate at first years and second years in the observation group were significantly lower than those in the control group （ 10. 5% and 26. 3% vs 31.6% and 47.4% ）. The 1- year and 2-year survival rates were significantly higher in the the observation group than in the control group（76. 3% and 50. 0% vs 55.3% and 26. 3% ） （all P 〈0.05）. There was no difference in the adverse reac- tions between the two groups （ P 〉 0. 05 ）. Conclusion Stereotactic radiotherapy combined with gemcit- abine in the treatment of locally advanced pancreatic cancer is relatively safe and effective, which can con- trol the disease and improve the 2-year survival time.