局部晚期胰腺癌三维适形放疗联合健择化疗疗效分析

目的观察三维适形放射治疗（3d-CRT）联合健择化疗治疗局部晚期胰腺癌的疗效及耐受性。方法27例局部晚期胰腺癌进入三维适形放射治疗联合健择化疗治疗组，化疗方案健择1000mg／m^2，第1、8、15天，每4周为1周期，共治疗2周期。同步进行3d-CRT，计划照射剂量6mV／15mYV—X线：4—5Gy／次／d，每周3次，DT50—60Gy／10～12次。结果27例患者全部完成治疗计划，胰腺癌原发灶完全缓解（CR）为22．2％（6／27），部分缓解（PR）66．7％（18／27），总有效率为（CR＋PR）88．9％（24／27），无变化和进展（NC＋PD）占11．1％（3／27）。临床获益率为81．5％（22／27）。中位随访期为32（24～37）个月。1年生存率为74．1％（20／27），2年生存率为48．1％（13／27），中位生存期26个月。白细胞下降发生率及胃肠道反应发生率分别为100．0％（27／27）、96．3％（26／27）。结论三维适形放射治疗联合健择化疗治疗局部晚期胰腺癌疗效较好，可以明显提高患者的生活质量和生存期，不良反应能为多数患者耐受，是治疗局部晚期胰腺癌的较好的方法。

Three dimensional-conformal with gemcitabine chemotherapy for locally advanced pancreatic cancers

Objective To evaluate the acute side effects and efficacy of three dimensional-cnnfor malradiotherapy combined with gemcitabine chemotherapy for locally advanced pancreatic cancers Methods 27 patients with locally advanced pancreatic cancers were treated with Three dimensional-eonformal radiotherapy combined with gcmcitabine chemotherapy. Results The complete response rate (CR), partly response rate (PR), overall respons rate (CR + PR) were22. 2% (6/27) ,66.7 % (18/27) and 81.5 % ( 22/27 ) respectively.Clinical benefit response(CBR) 81.5% (22/27) ,the 1-year and 2-year survival rate were 74. 1% (20/27) and 48.1% (13/27) respectively. Acute leukocytopenia occurred, the alimentary canal response rate were100. 1%(27/27) and 96. 3 % (26/27) respectively. Conclusion Three dimensional-eonformal radiotherapy with gem-eitabine chemotherapy is well tolerated and improved response rate in moat patients with locally advanced pan-creatic cancers.