伽玛刀治疗晚期胰腺癌的临床研究

目的　探讨立体定向放射治疗晚期胰腺癌的近期临床疗效。方法　采用QUR QGD型立体定向伽玛射线体部治疗系统 (体部伽玛刀 )治疗 16例晚期胰腺癌患者。本组病例伽玛刀治疗等剂量曲线为 5 5 %～ 70 % ;肿瘤≤ 5cm的单次周边剂量 4 0～ 5 5Gy ,肿瘤 >5cm的单次周边剂量 3 0～ 4 0Gy ;治疗总剂量为32～ 4 8Gy ;治疗次数 8～ 11次 ,大多数患者为隔日治疗。结果　伽玛刀治疗过程中部分患者上腹部及腰背部疼痛明显减轻 ,2位患者黄疸消退。伽玛刀治疗 3个月第一次复查 ,病变部位达到完全缓解 3例 ,部分缓解 13例 ;总有效率 (完全缓解 +部分缓解 ) 10 0 %。 6个月复查 ,病变部位达到完全缓解 5例 ,部分缓解 9例 ,无变化2例 ;总的症状、体征缓解率为 81 2 5 % (13/16 )。未见穿孔、大出血、持续高热等严重并发症发生。结论　体部伽玛刀治疗晚期胰腺癌能使肿瘤局部得到准确的高剂量照射 ,周围正常组织损伤小 ,近期疗效理想 ,为临床肿瘤医生提供了一个新的治疗手段。

Clinical Treatment of Advanced Pancreatic Carcinoma with Gamma Rays

Objective To discuss the feasibility of treating advanced pancreatic carcinoma (PC) with stereotectic radiation Treatment (SRT). Methods 16 cases of Advanced PC were treated with OUR-QCD type Stereotectic Radiotherapy Gamma Rays System. Dose curve of this group of cases was 55%~70%. Encircled dose for carcinoma less than or equal to 5 cm was 4.5~6.0 Gy per fraction, and for carcinoma greater than 5 cm was 3.5~5.0 Gy per fraction. The range of total dose was 32~48 Gy. Number of treatment was 5~9. Majority of the patients were treated every other day. Results During the SRT period, significant pain relief was observed in upper abdomen, waist and back, and jaundice of two cases faded. After 3 months treatment with SRT, there were 3 cases CR and 5 cases PR. Efficacious ratio (CR+PR) was 100%. After 6 months treatment with SRT,there were 5 cases CR, 9 cases PR and 2 cases NC. Mitigation of symptom was 81.25% (13/16). No perforation, serious bleeding or continuous high fever was observed. Conclusion Treating Advanced PC with SRT ensures high-dose radiation for Pancreatic carcinoma, with little damage to the normal tissues nearby. SRT provides clinical radiotherapists with a safe and efficient treatment method.