摘要
目的探讨体部伽玛刀序贯吉西他滨联合洛铂方案治疗不能手术切除胰腺癌的疗效和毒副反应。方法回顾性分析30例不能手术切除的行体部伽玛刀序贯吉西他滨联合洛铂方案治疗的胰腺癌患者的临床资料。体部伽玛刀治疗:40%～60%的等剂量曲线覆盖95%的靶区体积,肿瘤直径>3cm,单次剂量3～3.5Gy,每日1次,5次/周,治疗9～11次;直径≤3cm,单次剂量3.5～4.0Gy,每日1次,5次/周,治疗8～9次。总剂量为31.5～45Gy。化疗方案:吉西他滨1000mg/m2静滴,d1、d8;洛铂30～40mg/m2静滴,d1。于伽玛刀治疗结束后第1天开始,21天为1个周期,共4个周期。结果 30例患者中24例按计划完成放、化疗。全组患者获CR 3例,PR 16例,SD 6例,PD 5例,有效率为63.3%,临床获益率为80.0%。30例患者的中位生存期为11.6个月,1、2年生存率分别为39.0%和9.6%。主要毒副反应为消化道反应和血液学毒性,以恶心呕吐、白细胞减少和血小板减少为主,均为1～3级。结论对于不能手术切除的胰腺癌患者,体部伽玛刀序贯吉西他滨联合洛铂方案的疗效较好且安全,值得进一步开展临床研究。
Objective To investigate the efficacy of body gamma knife sequential gemcitabine plus lobaplatin regimen on unresectable pancreatic cancer. Methods Retrospective analysis of body gamma knife sequential gemcitabine plus lobaplatin regimen was made on 30 cases of unresectable pancreatic cancer. The isodose curve of body gamma knife was 40% -60% and covered about 95% of the target volume. For tumor more than 3cm in diameter, the single dose was 3-3.5Gy, once per day, and 5 times for a week with a to- tal of 9 to 11 times. For the tumor less than 3cm in diameter, the single dose was 3.5-4Gy, once per day, and 5 times a week with a total of 8 to 9 times. The total dose was 31.5-45Gy. Gemcitabine 1000mg/m^2 iv d1 , d8 ; lobaplatin 30-40mg/m^2 iv, dI. Twenty-one days was a cycle. 4 cycles was performed after the body gamma knife therapy. Results Twenty-four completed radiotherapy and chemotherapy in the 30 patients, with 3 cases in CR, 16 cases in PR, 6 case in SD, 5 cases in PD, and the response rate was 63.3%. The clinic benefit rate was 80. 0%. The median overall survival was 11.6 months and the 1-, 2-year survival rates were 39. 0% and 9. 6%. The major adverse reactions were the digestive system reaction and haematological toxicity. The main manifestations were nausea and vomiting, leucopenia and thrombocytopenia with grade 1-3. No grade 4 adverse reaction was observed. Conclusion For patients with unresectable pancreatic carcinoma, body gamma knife sequential gemcitabine plus lobaplatin regimen can bring a survival benefit with tolerable adverse reaction, and worth further study.
出处
《临床肿瘤学杂志》
CAS
2012年第10期927-930,共4页
Chinese Clinical Oncology
关键词
胰腺癌
体部伽玛刀
化疗
生存质量
Pancreatic carcinoma
Body gamma knife
Chemotherapy
Quality of life
