立体定向体部放射治疗对早期胰腺癌患者生存期的影响

Influence of stereotactic body radiation therapy on the survival of patients with early stage pancreatic cancer

目的 分析立体定向体部放射治疗(SBRT)对早期胰腺癌患者生存期的影响.方法 回顾性分析海军军医大学附属长海医院放疗科2012年1月至2016年12月间收治的103例T1-2N0M0期胰腺癌患者经SBRT治疗后的临床资料.采用Kaplan-Meier法进行生存分析,通过Cox比例风险模型筛选影响患者生存期的相关因素.结果 对于无法接受手术治疗或拒绝手术治疗的T1-2N0 M0期胰腺癌患者,SBRT治疗后患者中位总生存期为17.7(16.1 ~19.3)个月,1年和2年生存率分别为86.3%和24.6%.中位无疾病进展生存期(PFS)为13.0(10.7 ~15.3)个月,1年和2年无疾病进展生存率分别为54.5%和6.3%.联合放化疗、接受生物等效剂量(BED10) ≥60 Gy及治疗后CA19-9下降>50%的患者具有更长的生存期及PFS.结论 SBRT是T1-2N0M0期胰腺癌患者有效而安全的治疗方式.

Objective To evaluate the efficacy of stereotactic body radiation therapy (SBRT) on the survival of patients with early stage pancreatic cancer.Methods The clinical data of 103 T1-2N0M0 pancreatic cancer patients treated by CyberKnife SBRT at the Department of Radiation Oncology of Changhai Hospital from January 2012 to December 2016 was retrospectively analyzed.Kaplan-Meier method was used for survival analysis and Cox proportional hazards model was utilized to identify survival related factors.Results The median overall survival(OS) of T1-2N0M0 pancreatic cancer patients who had unresectable pancreatic cancer or refused surgery was 17.7 (16.1-19.3) months.1-year and 2-year OS rate were 86.3% and 24.6%,respectively.The median progression free survival(PFS) was 13.0(10.7-15.3) months.1-year and 2-year PFS rate were 54.5% and 6.3%,respectively.Patients with chemoradiation,BED10 ≥60 Gy and CA19-9 decrease > 50% after treatment had longer OS and PFS.Conclusions SBRT is a safe and effective treatment for patients with T1-2N0M0 pancreatic cancer.