立体定向适形放疗治疗晚期胰腺癌32例

目的：分析立体定向适形放疗对晚期胰腺癌的临床价值。方法：对32例晚期胰腺癌患者行6MV-x线同中心适形逐野照射。6Gy／次～12Gy／次，分割3次～8次，间隔l天～2天，总量24Gy～48Gy／7天～24天。结果：放疗结束时腹痛完全缓解27例，有效率84．37％。退黄13／19，有效率68．42％。食欲好转12／32，有效率40％。放疗后1月～3月行B超或CT复查，肿瘤全消13．04％。部分消退或肿瘤中心液化56．52％，客观有效率69．56％，随访3个月内死亡9例，生存12个月以上6例，1年生存率为30％(6／20)，平均生存7．8个月。结论：立体定向适形放疗可使晚期胰腺癌改善症状，止痛退黄，提高生活质量，相对延长生存期。

STEREOTACTIC CONFORMAL RADIOTHERAPY FOR ADVANCED PANCREATIC CANCER: A REPORT OF 32 CASES

Objective:To evaluate the therapeatic effect of stereotactic conformal radiotherapy for advanced pancreatic cancer.Methods:Patients were fixed with vac-lok cushion of the device of stereotactic localization.Radio-opaque markers were used to localize skin marks.CT simulation integrated CT scanning,target definition,radiation beam orientation,treatment portal specification and simulation imaging into a highly accurate and efficient 3D TPS.After the completion of three dimensional design and field shaping,stereotactic conformal radiotherapy was given by the isocentral treatment(SAD METHOD)with 6 MVX-ray.All patients received a total dose of 24-48 Gy/7-24 days,3-8 fractions and 6-12 Gy per fraction with an interval of 1-2 days.Results:After radiotherapy,abdominal pain was relieved completely in 27 of these 32 patients(84.37 %),jaundice disappeared in 13 of 19 patients(68.42 %) and appetite was improved in 12 of 32 patients(37.50 %).Up to the time of reexamination at 1-3 months after radiotherapy,of 23 patients,3patients(13.04 %) had complete regression of tumors,13 patients(56.52 %) had partial regression of tumors of colliquative necrosis in the center of tumors.The overall response rate(CR+PR) was 69.56 %.Nine patients died within 3 months,6 patients survived for more than 12 months.The average suvival time was 7.8 months.Conclusion:Stereotactic conformal radiotherapy for advanced pancreatic cancer may relieve symptoms,such as abdominal pain and jaundice.It is an effective approadch to improve life quality and prolong survival time for advanced pancreatic cancer.