晚期胰腺癌超级伽玛刀治疗的临床研究

Clinical study of super gamma knife in the treatment of advanced pancreatic cancer

目的探讨晚期胰腺癌超级伽玛刀治疗的临床效果。方法选取2015年1月—2019年1月我院收治的晚期胰腺癌患者46例,随机分为对照组(23例)与观察组(23例),对照组接受单纯化疗治疗,观察组患者接受超级伽玛刀方案治疗。收集两组患者的治疗有效率、生存时间的临床受益反应(CBR)等指标,进行对比分析。结果接受不同治疗措施干预1个月后,对两组患者治疗总有效率进行比较。观察组患者治疗总有效率为60.87%,高于对照组患者治疗总有效率13.04%(P<0.01)。观察组患者中疼痛程度改善阳性人数比例、KPS体力改善阳性人数比例和体质量改善阳性人数比例均高于对照组患者(P<0.05),但两组患者镇痛药物消耗量改善阳性人数比例差异并无统计学意义(P>0.05)。观察组患者无进展生存期中位时间为4个月(95%CI,2.124±5.274),对照组患者无进展生存期中位时间为3个月(95%CI,1.804±4.851)。观察组患者无进展生存期中位时间长于对照组患者(P=0.042<0.05)。结论基于立体定向伽马射线全身治疗系统的超级伽玛刀采用中等剂量分割方法治疗晚期胰腺癌,其临床效果切实,副作用相对较低,对患者生存治疗有明显提升效果,值得临床推广。

Objective To explore the clinical effect of super gamma knife in the treatment of advanced pancreatic cancer.Methods 46 patients with advanced pancreatic cancer admitted to our hospital from January 2015 to January 2019 were randomly divided into control group(23 cases)and observation group(23 cases).The control group received chemotherapy only;the observation group received super gamma knife treatment.We collected the clinical benefit response(CBR)and other indicators of treatment efficiency and survival time of the two groups for comparative analysis.Results One month after the intervention of different treatment measures,the total effective rate of the two groups was compared.The total effective rate of the observation group was 60.87%,which was higher than that of the control group(13.04%)(P<0.01).The positive rate of pain degree improvement,KPS physical strength improvement,body weight improvement in the observation group were all higher than those in the control group(P<0.05),but there was no statistical significance between the two groups in the positive rate of analgesic consumption improvement(P>0.05).The median time of progression free survival was 4 months(95%CI,2.124±5.274)in the observation group and 3 months(95%CI,1.804±4.851)in the control group.The median time of progression free survival in the observation group was longer than that in the control group(P=0.042<0.05).Conclusion The super gamma knife based on the stereotactic gamma ray systemic therapy system uses the medium dose segmentation method to treat the advanced pancreatic cancer.Its clinical effect is practical,the side effects are relatively low,and the survival treatment of patients has a significant improvement effect,which is worthy of clinical promotion.