摘要
目的 观察三维适形放射治疗（3D-CRT）联合吉西他滨（GEM）＋氟脲嘧啶（5-FU）（GF方案）同期化疗治疗局部晚期胰腺癌（LAPC）的疗效及毒性反应.方法 将39例LAPC患者分为同期放化疗组（同期组）19例和序贯放化疗组（序贯组）20例.所有患者化疗均予以GEM 800 mg/m2,5-FU 500 mg/m2,d1、d8、d15.放疗予以3D-CRT,常规分割,2 Gy/次,5次/w,肿瘤剂量30～64 Gy/3～6.5 w,中位剂量46 Gy.比较两组的生存率、近期疗效、不同病灶的疗效、全身情况及毒副反应发生情况,并分析CA19-9及放疗剂量与肿瘤生存的关系.结果 同期组的生存率明显优于序贯组,总有效率显著高于序贯组,且远处转移发生率明显低于序贯组,差异均有统计学意义;两组胰体尾癌的总有效率显著高于胰头癌的总有效率,差异有统计学意义;两组主要不良反应为骨髓抑制、恶心、呕吐、腹泻及皮疹;同期组患者治疗后KPS评分下降者明显少于序贯组.在随访过程中发现,放疗剂量与肿瘤生存具有一定相关性.结论 3D-CRT加固期GF方案化疗能明显延长LAPC患者的生存期,改善全身状况,减少远处转移的发生,且不良反应患者可耐受.
Objective To observe the efficiency and toxicity of three dimensional conformal radiotherapy（3D- CRT） combined with concurrent gemcitabine （GEM） and 5-fluorouracil （5-Fu） （GF regimen） chemotherapy for local advanced pancreatic cancer（LAPC）. Methods Thirty nine patients with LAPC were randomly divided into the concurrent chemo-radiotherapy group （concurrent group, 19 cases ） and sequential chemo-radiotberapy group （sequential group,20 cases）. All patients were given chemotherapy with GEM 800 mg/m2 and 5-FU 500 mg/m2 on dl,d8 and d15.3DCRT was given by 2 Gy every time and five times a week. A total dosage of 30 64 Gy/3-6. 5 weeks was given,and the median dose was 46 Gy. The survival rate,short-term effect,efficiency on different lesions, general condition and incidence of adverse reactions in two groups was compared. Results The survival rate, total effective rate and incidence of distal metastasis was respectively superior/higher/lower in concurrent group than in sequential group,with significant differences. The total effective rates of pancreatic body tail cancer in both groups were higher than pancreatic head cancer, with significant difference. The major adverse reactions of two groups were myelosuppression,nausea, vomiting, diarrhea and rash. The patients with decreased Karnofsky performance status （KPS）scores after treatment were less in concurrent group than in sequential group. In the period o{ follow up,it was found that radiotherapy dose was associated with the survival of tumors. Conclusion 3D-CRT combined with concurrent GF regimen chemotherapy can obviously prolong the survival time of patients with LAPC, ameliorate general condition, decrease incidence of distal metastasis and has tolerable adverse reactions.
出处
《成都医学院学报》
CAS
2013年第6期676-679,共4页
Journal of Chengdu Medical College
基金
中国高校医学期刊临床专项资金(NO:11321214)
关键词
胰腺癌
三维适形放射治疗
化疗
预后
Pancreatic Cancer
Three Dimensional Conformal Radiotherapy
Chemotherapy
Prognosis
