立体定向适形放疗晚期胰腺癌的临床研究

The investigation of the fractionated stereotatic radiotherapy for the late pancreatic carcinoma

目的 立体定向适形放疗(SRT)在晚期胰腺癌中的临床应用。方法 2000年3月至2002年3月对38例晚期胰腺癌患者给予立体定向适形放疗,采用铅限束筒高剂量低分割方法,肿瘤总剂量DT 35～48Gy,分5～7次,单次剂量5～8Gy,每周3次。随访期6月～3年。结果 3个月CT复查:CR 10.5％,PR 47.4％,总有效率(CR+PR)57.9％。6、9、12、24个月生存率:86.8％、52.6％、3.95％、12.5％。中位生存期11.5个月。腹痛缓解率90.5％,黄疸消减率84.2％ KPS计分上升者52.6％,平均上升18％。急性胃肠道反应(Ⅰ、Ⅱ级)81.6％,血象下降(Ⅰ、Ⅱ级)34.2％,经处理后未影响治疗完成,未见后期并发症。结论 SRT治疗晚期胰腺癌,定位准确,疗程短,副作用小,疗效显著,对难以手术切除或术后复发的病人不失为一种有效的治疗方法。

Objective To investigate the effect of the late pancreatic carcinoma treated by stereotactic radiotherapy (SRT). Methods From March2000 to March 2002, 38 patients with late pancreatic carcinoma received SRT. The local tumor dose was 35-48GY/5-7f by means of three times a week. The follow-up period ranged from 6 months to 3 years. Results The results at three months examined by CT showed that the CR was 10.5%, PR 47.4%, CR+PR57.9%. The 6 months survival rates were 86.8% , 9 months 52.6%, 12 months 39.5% and 24 months were 12.5% . The median survival stage was 11.5 months. Abdominal pain relieving rate was 90.5% and jaundice vanishing rate was 84.2% . Kps integretien added up to 52.6%, the median 18% . Acute gastrointestinal ( I It grade)rate was 81.6% and the overall leucopenia ( Ⅰ Ⅱ grade) rate was 95.8%, but this didn't affect the achievement of the treatment. And it had no late complication. Conclusion The treatment of late pancreatic carcinoma by SRT is a new effective method which improves local control especially for those who can't be operated or suffer from recurrence.