中药联合靶中靶放射治疗42例局部晚期不可手术的胰腺癌临床观察

目的：观察评价中药联合靶中靶放射治疗局部晚期不可手术的胰腺癌的疗效和放射治疗副反应。方法：对我院自2008年10月至2011年12月采用中药联合靶中靶放射治疗的42例局部晚期不可手术的胰腺癌患者行回顾性分析。三维适形或调强放疗实现靶区剂量层层递增,单纯放疗29例,同步放化疗加中药乌梅丸加减治疗13例,所有患者均使用中药康艾注射液。结果：原发灶完全缓解率CR（12/42）28.6%、部分缓解率PR（20/42）47.6%,总有效率（CR＋PR）为76.2%;全组中位生存时间和1年总生存率（OS）分别为14.8个月和51.7%。同步化疗的加入较单放有提高生存的趋势但尚未达统计学意义（P=0.089）。放疗末总临床获益者31例,主要为腹痛缓解23例。不良反应主要表现为急性消化道反应。结论：康艾注射液联合靶中靶放射治疗局部晚期不可手术的胰腺癌采用靶区剂量层层递增的模式是安全有效的,毒副反应低,可提高临床获益。加同步化疗联合中药乌梅丸有提高生存率趋势。

Clinical Observation on Traditional Chinese Medicine along with Target in Target Radiation Therapy Treating Inoperable Advanced Pancreatic Cancer

Objective： To evaluate the efficacy and side reactions of Traditional Chinese Medicine along with target in target radiation therapy in patients with inoperable advanced pancreatic cancer. Methods： Retrospective analysis was given to 42 patients with inoperable advanced pancreatic cancer admitted to our hospital from October 2000 to December 2012. Patients were treated with Kangai injection and three-dimensional conformal radiation therapy（ 3D-CRT） or Intensity-modulated radiation therapy（ IMRT）. Low-speed computed tomography simulation was conducted. Among these,thirteen patients received concurrent chemotherapy and modified Wu Mei Wan.Results： The complete response rate（ CR） and the partial response rate（ PR） in the primary tumors were 28. 6% and 47. 6%,and the overall response rate（ CR ＋ PR） was 76. 2%. The median survival time（ MST） and 1-year overall survival rate（ OS） was 14. 8 months and 51. 7%. Concurrent chemoradiotherapy tended to improve overall survival（ P = 0. 089）. After treatment,31 patients had clinical benefit response,mainly abdominal pain relief. Conclusion： Kangai injection and target in target radiation therapy is effective in alleviation of disease-related symptoms in patients with inoperable pancreatic cancer,though concurrent chemoradiotherapy with Wu Mei Wan confers a trend of survival improvement over sole radiotherapy.