晚期胰腺癌姑息术后放射治疗和同步化疗疗效分析

目的　评价放射治疗 +同步化疗治疗不能手术切除的胰腺癌的临床疗效和毒副反应。方法　 32例晚期不能手术切除的胰腺癌于姑息术后 ,给予放射治疗 +同步化疗 (S +R +C组 ) ,化疗方案采用 5 氟尿嘧啶 5 0 0mg /m2 +甲酰四氢叶酸钙2 0 0mg /m2 ,第 1～ 3天 ,第 2 2～ 2 4天。并与同期 31例姑息手术 +放射治疗 (S +R组 )和 34例姑息手术病人 (S组 )的治疗结果对照。结果　S +R +C组 7例 (2 1.9% )病灶缩小 ,16例 (5 0 % )病灶稳定 ;S +R组 5例 (16 .1% )病灶缩小 ,15例 (48.4 % )病灶稳定。S +R +C组病人有效率为 2 1.9% ,S +R组为 16 .1%。伴有疼痛的病人经治疗 ,疼痛缓解率分别为 5 2 .4 %和 4 2 .1%。S +R +C组和S +R组、S组比较 ,中位生存时间分别为 9.6月和 7.2月、5 .8月。S +R +C组与S组比较 ,有生存率优势 (P <0 .0 5 )。结论　放射治疗 +同步化疗可提高不能手术根除的胰腺癌病人的局部控制率和生存率。

Results of unresectable pancreatic adenocarcinoma treated with concurrent chemoradiation

ObjectiveTo investigate the toxicity and effect of concurrent chemoradiation in treating unresectable pancreatic adenocarcinoma. MethodsAfter palliative operation ,32 patients with locally unresectable adenocarcinoma of pancreas were treated with concurrent chemoradiation(SRC group). Chemotherapy was given with 5-fluorouracil (5-FU)500 mg /m 2 and leucovorin 200 mg /m 2 during day 1-3 and 22-24. Their median survival was compared to the SR group with radiation therapy after palliative operation(31 patients) and the S group with palliative operation only (34 patients). ResultsIn SRC group the overall response rate was 21.9%, including 7(21.9%) PR and 16 (50%) NC, the rate of pain relief was 52.4%. In SR group the response rate was 16.1%, including 5(16.1%) PR, 15 (48.4%) NC and the rate of pain relief was 42.1% .The median overall survival was 9.6 months for SRC group, 7.2 months for SR group and 5.8 months for S group. The concurrent chemoradiation group produced a significant survival improvement when compared with the simple palliative operation group(P<0.05). ConclusionConcurrent chemoradiation showed a trend toward increased median survival and local control in unresectable pancreatic adenocarcinoma patients.