高剂量少分次放疗联合白蛋白结合型紫杉醇、替吉奥方案化疗在局部晚期胰腺癌患者中的临床疗效以及安全性评价

The clinical efficacy and safety evaluation of high-dose and fractionated radiotherapy combined with albumin-bound paclitaxel and Tiggio chemotherapy in patients with locally advanced pancreatic cancer

目的研究高剂量少分次放疗联合白蛋白结合型紫杉醇、替吉奥方案化疗在局部晚期胰腺癌患者中的临床疗效以及治疗相关不良反应。方法选取2018年9月—2020年11月中国科学院合肥肿瘤医院收治的72例局部晚期胰腺癌患者,分为对照组36例和实验组36例,对照组患者给予白蛋白结合型紫杉醇、替吉奥方案化疗,实验组患者在对照组基础上,给予胰腺癌病灶高剂量少分次放疗。最终对照组入组34例,实验组入组33例。观察两组患者总生存期(OS)、无进展生存期(PFS)、客观有效率(ORR)、疾病控制率(DCR)以及治疗相关不良反应发生率。结果实验组患者中位OS和中位PFS分别为12.4个月和6.3个月,长于对照组的8.5个月和4.2个月(P<0.05);ORR为21.21%,虽高于对照组的5.88%,但差异无统计学意义(P>0.05);DCR为66.67%,高于对照组的38.24%(P<0.05);血清CEA、CA19-9、CA724和CTC表达水平均显著低于对照组(P<0.05)。两组患者乏力、肝功能损伤、骨髓抑制、感觉神经毒性和关节痛/肌肉痛不良反应发生率差异无统计学意义(P>0.05);实验组患者胃肠反应发生率高于对照组(P<0.05),但可控可耐受。结论高剂量少分次放疗联合白蛋白结合型紫杉醇、替吉奥方案化疗在局部晚期胰腺癌患者中临床疗效显著,有效延长生存期,治疗相关不良反应可控,值得临床推广。

Objective The aim of this study was to study the clinical efficacy and treatment-related adverse reactions of high-dose and fractionated radiotherapy combined with albumin-bound paclitaxel and Tiggio chemotherapy in patients with locally advanced pancreatic cancer.Methods A total of 72 locally advanced pancreatic cancer patients who were admitted to Hefei Cancer Hospital of Chinese Academy of Sciences from September 2018 to November 2020 were selected and divided them into the control group of 36 cases and experimental group of 36 cases.The patients in the control group were given chemotherapy with nab-paclitaxel and Sigiroid,and the patients in the experimental group were given high-dose and less-fractionated radiotherapy for pancreatic cancer on the basis of the control group.Finally,34 cases in the control group and 33 cases in the experimental group were included.The overall survival(OS),progression-free survival(PFS),objective response rate(ORR),disease control rate(DCR),and incidence of treatment-related adverse reactions were observed.Results The median OS and median PFS of the experimental group were 12.4 months and 6.3 months,respectively,which were longer than 8.5 months and 4.2 months in the control group(P<0.05);the ORR was 21.21%,although higher than that in the control group(5.88%),but the difference is not statistically significant(P>0.05);DCR was 66.67%,which was higher than that in the control group(38.24%)(P<0.05);the levels of serum CEA,CA19-9,CA724 and CTC were significantly lower than those of the control group(P<0.05).There was no significant difference in the incidence of fatigue,liver function damage,bone marrow suppression,sensory neurotoxicity,and pain/myalgia adverse reactions between the two groups(P>0.05);the incidence of gastrointestinal reactions in the experimental group was higher than that in the control group(P<0.05);but they were controllable and tolerable.Conclusion High-dose and fractionated radiotherapy combined with albumin-bound paclitaxel and Tiggio chemotherapy have significant clinical effects on patients with locally advanced pancreatic cancer,effectively prolonging survival period,and controllable treatment-related adverse reactions,which is worthy of clinical promotion.