超级伽玛刀治疗胰腺癌的疗效及安全性探讨

目的 评价超级伽玛刀治疗胰腺癌的安全性和有效性.方法 47例胰腺癌病人接受超级伽玛刀治疗,在临床靶区(CTV)边缘外放5～10 mm形成计划靶区(PTV),治疗采用深圳海博公司的SGS-I型立体定向伽玛射线治疗系统,治疗边缘剂量2.5～4 Gy/次,9～23次,5次/周,边缘累计剂量33～57.5 Gy,观察病人的有效率、生存时间和临床受益反应(CBR).结果 总有效率(CR+PR)84.1%,1年局控率58%,2年局控率38%,疼痛完全缓解率57.1%,总缓解率89.3%,临床受益反应(CBR)有效率64.4%;中位生存期12个月,平均生存期13.6个月,1、2年生存率55.3%、17.5%.RTOGⅠ～Ⅱ级胃肠道反应发生率43.2%,无RTOGⅢ胃肠道反应者.结论 S GS-I型立体定向伽玛射线治疗系统采用中等剂量 分割的方法治疗胰腺癌是有效的,并且副作用很低,明显提高了病人的生存质量.

Efficacy and safety of whole-body stereotactic radiation treatment sytem for patients with pancreatic carcinoma

Objective To evaluate the efficacy and safety of whole-body stereotactic radiation treatment system (SGS-I) for pancreatic carcinoma (PC) and investigate the reaction of patients to the treatment. Methods From April 2004 to January 2007,47 patients with stage Ⅰ-Ⅳ PC were treated with the system in our hospital. The margin of PTV was over 0.5-1.0 cm in GTV, 50%-60% dose line was prescribed dose curve and covered over 90% area of PTV. The patients were irradiated with 2.5-4 Gy/fraction, 5 d a week, 9-23 fractions and at a total dose of 33-57.5 Gy was delivered at the tumor margin. Results The complete response rate (CR) and partial response rate (PR) in the pri- mary tumor were 15.9% and 68.2% respectively. The overall response rate (CR+PR) was 84.1% and the rate of clinical benefit response (CBR) was 64.4%. The mean survival time was 13.6 months and the median survival time was 12 months. The 1- and 2-year overall survival rates were 55.3% and 17.5%, respectively. The 1- and 2-year overall local control rates were 58% and 38%. Acute gastro-intestinal reaction was found in 43.2% for RTOG grade Ⅰ-Ⅱ and none for RTOG grade Ⅲ. The whole process was bearable for all the patients after allopathy. Conclusion This new technique,which is non-invasive and painless, is effective and safe and can improve the local control rate and sur-vival rate and survival quality of patients with local advanced pancreatic carcinoma.