不同剂量分割模式的三维适形放疗对局部进展期胰腺癌的疗效分析

目的探讨局部进展期胰腺癌三维适形放疗最佳时间剂量分割模式。方法30例进展期胰腺癌患者随机分为两组,常规组15例,接受常规剂量分割(1.8~2 Gy/次,5次/周),低分割组15例,剂量分割(3~5 Gy/次,3~5次/周)。两组患者等效生物剂量相同(56 Gy)。结果常规组和低分割组有效率分别为46.7%和53.3%,1年生存率分别为20.0%和26.7%,差异无显著性。常规组和低分割组临床受益反应率分别为86.6%和53.3%,两组比较差异有显著性(P<0.05)。常规组疼痛缓解率86.6%,低分割组60.0%(P>0.05)。结论常规剂量分割的三维适形放疗治疗局部进展期胰腺癌急性放射反应轻,能有效改善临床症状,提高生活质量,延长生存期。

Efficacy of different time-dose fraction schemes of three-dimensional conformal radiotherapy in treatment of advanced pancreatic carcinoma

Objective To explore the ideal timedose fraction scheme of three-dimensional conformal radiotherapy(3D-CRT)for advanced pancreatic carcinoma.Methods Thirty patients with advanced pancreatic carcinoma were randomized into two groups: routine radiotherapy group and unconventional radiotherapy group.On the basis of 3D-CRT,the two groups were treated respectively with routine dose fractions(1.8-2 Gy/f,5f/W)and high dose fractions(3-5 Gy/f,3-5f/W).The equivalent biological effective dose of the 2 groups was 56Gy.Results The response rate in routine radiotherapy group and unconventional radiotherapy group were 46.7% and 53.3% respectively.One-year survival rates were 20.0% in routine radiotherapy group and 26.7% in unconventional radiotherapy group(P>0.05).Clinical benefit response(CBR) rate showed significant difference between routine radiotherapy group(86.6%)and unconventional radiotherapy group(53.3%)(P<0.05).The remission rates of abdominal pain were 86.6% and 60.0% respectively(P>0.05).Conclusion 3D-CRT with routine dose conventional fraction for treatment of advanced pancreatic carcinoma may relieve acute radiation reactions.It is an effective approach to improve life quality and prolong survival time.