介入化疗联合伽玛刀治疗胰腺癌27例临床分析

目的探讨介入化疗联合伽玛刀治疗晚期胰腺癌的疗效。方法采用Seldinger插管技术对胰腺供血动脉灌注化疗药物：吉西他滨1．2—1．6g，顺铂60—80mg，5-氟尿嘧啶（5-FU）1．0～1．5g，28天重复，共2周期；介入化疗2周后行伽玛刀治疗，50％-70％等剂量曲线包绕95％以上肿瘤，3—5Gy／次，3～5次／周，总剂量36～48Gv。结果27例患者1年总生存率48．1％（13／27），2年生存率25．9％（7／27）；中位生存时间为10．8个月。近期疗效：完全缓解（CR）51．9％（14／27），部分缓解（PR）44．4％（12／27），病情稳定（SD）3．7％（1／27），总有效率（CR＋PR）96．3％（26／27）。临床受益反应100％（27／27），无严重毒副反应发生。结论介入化疗联合伽玛刀治疗晚期胰腺癌疗效较好。

Efficacy of body gamma- knife radiotherapy combined with intra- arterial infusion chemotherapy for advanced pancreatic cancer

Objective To evaluate the efficacy of body gamma - knife radiotherapy combined with intra - arterial infusion chemotherapy for advanced pancreatic cancer. Methods Twenty - seven patients who were diagnosed with ad- vanced pancreatic cancer were studied. Transcatheter pancreatic arterial infusion chemotherapy was performed, and the infusion drugs included gemcitabine （ 1.2 - 1.6 g） , cisplatin （60 - 80 mg） , 5 - Fu （ 1.0 - 1.5 g） and leucovorin （300 mg）. The infusion chemotherapy was repeated for 2 times. Two weeks after the infusion chemotherapy, body gamma - knife radiotherapy was performed with 8 - 12 fractions, 3.0 - 5.0 Gy per fraction/day, 3 ~ 5 times a week, 50% ~ 70% isodose line covering more than 95% GTV （ gross tumor volume） and total tumor marginal dose of 36 -48 Gy. Results The clinical response rate （ CR ＋ PR） was 96.3% （26/27） , among which CR 51.9% （ 14/27）, PR 44.4% （12/27）. One patient showed SD （1/27, 3.7% ）. The clinical benefit response rate was 100% （27/27）. No serious toxicity was observed. The 1 - and 2 -year survival rates were 48.1% （13/27） and 25.9% （7/27） , respectively, and the median survival time was 10.8 months. Conclusions Body gamma - knife radiotherapy combined with intra - arterial infusion chemotherapy is safe and effective for treating advanced pancreatic cancer.