42例晚期胰腺癌的术中放射治疗

目的　探讨姑息性手术结合术中放射治疗对晚期胰腺癌的疗效。方法　对 4 2例未能切除的晚期胰腺癌患者进行姑息性手术合并术中放疗。用 9～ 16MeV电子线在直视下照射病灶区域 ,照射量 2 0～ 30Gy。同时与未行术中放疗的 5 9例患者进行对比。结果　术中放疗组患者腹痛和腰背痛完全缓解率为 6 6 .7% ,部分缓解率为 2 6 .2 % ,总有效率为 92 .9%。未行术中放疗的 5 9例患者腹痛和腰背痛完全缓解率为 15 .3% ,部分缓解率为 2 5 .4 % ,总有效率为 4 0 .7% (P <0 .0 0 1)。术中放疗组平均生存期为 16 .7个月 ,对照组为 11.9个月 (P >0 .0 5 )。结论　姑息性手术结合术中放疗能够有效地控制晚期胰腺癌患者的腹痛和腰背痛 ,改善生活质量 ,并可适当延长生存期。

Intraoperative radiotherapy for 42 patients with advanced pancreatic carcinoma

Objective To assess the effect of palliative operation combined with intraoperative radiotherapy (IORT) in the treatment of advanced pancreatic carcinoma. Methods 42 unresectable patients underwent palliative operation and IORT with 20-30 Gy by 9-16 MeV electron beam to the entire tumor field. Another 59 patients treated with palliative operation alone as control. Results The complete remission rate of abdominal and back pain in the IORT group is 66.7%, the partial remission rate is 26.2%, effective rate is 92.9%. In the control group, the complete remission rate is 15.3%, the partial remission rate is 25.4%, effective rate is 40.7% (P<0.001). Mean survival time of the IORT group is 16.7 months and in the control group is 11.9 months (P>0.05). Condusions Palliative operation combined with IORT can effectively remit abdominal and back pain of advanced pancreatic carcinoma, improve the quality of the patient's life.