射波刀治疗晚期胰腺癌回顾性分析

Retrospective analysis on advanced pancreatic cancer treatment by Cyberknife

目的 :回顾性分析射波刀对于晚期胰腺癌的治疗作用。方法 :收集2012年11月至2017年6月经射波刀治疗的晚期胰腺癌患者96例。采用PET/CT或增强CT定位,X-sight脊柱追踪照射,有梗阻性黄疸患者先行胆汁引流,缓解胆道梗阻有效后再行射波刀治疗。利用统计软件SPSS 13.0采用Cox Regression分析性别、年龄、KPS评分、肿瘤分期、CA19-9、放疗剂量、是否化疗、合并其他治疗等因素对生存期的影响,采用Kaplan-Meier法进行生存率分析,并对远期并发症情况进行分析。结果:87.5%的患者症状改善,平均生存时间为10.5个月、中位生存时间为8个月;肿瘤分期、CA19-9阳性是影响患者生存的主要因素(P<0.05),性别、年龄、KPS评分、放疗剂量、是否化疗、合并其他治疗等因素没有显著差异,对生存率影响不大(P>0.05);胰头癌远期的肠道、胆道并发症须引起注意。结论:射波刀是晚期胰腺癌有效的姑息治疗手段,可缓解局部症状,但对患者的生存期延长有限,远期并发症可危及生命。

Objective To evaluate the efficacy of Cyberknife for treating advanced pancreatic cancer retrospectively. Methods Totally 96 advanced pancreatic cancer patients were collected from November 2012 to June 2017, and then underwent Cyberknife treatment by positioning with PET/CT or enhancement CT as well as X-sight tracking exposure. The ones with obstructive jaundice went through biliary drainage before Cyberknife treatment. SPSS 13.0 was used for Cox Regression analyses on the influences of the factors on life span including gender, age, KPS score, tumor staging, CA19-9, therapeutic dose, chemotherapy, other therapies and so on. Survival rate was analyzed with Kaplan-Meier method, and late complications were discussed also. Results There were 87.5% patients had symptoms improved, the mean live time was 10.5 months, and the median live time was 8 months. Tumor staging and CA19-9 positivity were the main factors for patient survival （P〈0.05）, while the other factors had no significant influences on the survival rate including gender, age, KPS score, therapeutic dose, chemotherapy and other therapies （P〉0.05）. Late enteric and biliary complications had to be paid attention to for advanced pancreatic cancer. Conclusion Cyberknife is an eflective tool for palliative treatment of advanced pancreatic cancer, which relieves local symptoms while has limited influences on life span and may endanger patient life by late complications.