三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌.doc

三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌 　【摘要】 目的：评价三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌的疗效及毒性。方法：采用同时放化学疗法治疗局部晚期胰腺癌患者19例，放射治疗采用三维适形放射治疗，常规分割，共54～62 Gy；化学治疗第1～5天，替加氟 800 mg/d、顺铂 20 mg/d，21 d为1个周期，共4个周期；化学治疗与放射治疗同时在第1天开始。结果：治疗总有效率36.8%；治疗前后CA199均数分别为425 kU/L和79 kU/L，差异有统计学意义；中位生存时间为10.9个月，1年生存率42.1%，2年生存率21.1%。结论：三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌疗效与健择等其他同步化学治疗方案疗效相似，毒副反应患者能够耐受，值得进一步研究。 【关键词】 胰腺肿瘤 化学疗法 辅助 三维适形 放射疗法 辅助 【ABSTRACT】 Objective: To evaluate the effect and toxicity of concurrent chemo-radiotherapy consisting of three dimensional-conformal radiotherapy and cisplatin（CDDP）/tegafur（FT-207） infusion in patients with locally advanced pancreatic cancer. Methods: Nineteen patients with locally advanced pancreatic cancer were treated with concurrent chemoradiotherapy. Three dimension al-conformal radiotherapy of 54-62Gy was delivered at the rate of 1.8-2Gy per fraction. Concurrent chemoradiotherapy was given at the first day （Chemotherapy: FT-207 800mg/d and CDDP 20mg/d, 1-5 of 21-day cycle, at least four cycles.） The t-test was performed to compare the level of CA-199 before and after therapy. Overall survival rate was estimated by the Kaplan-Meier method. Results: The overall response rate was 36.8%. The level of CA-199 was 425u/ml before therapy and 79u/ml after therapy （Plt;0.02）. The median survival time was 10.9 months. The 1-year survival rate was 42.1% and 2-year survival rate was 21.1%. Conclusion: Three dimensional-conformal radiotherapy combined with FT-207 and CDDP chemotherapy had similar effect with concurrent gemcitabine （GEM） chemotherapy for the treatment of patients with locally advanced pancreatic cancer. 【KEY WORDS】 Pancreatic neoplasms·Chemotherapy,adjuvant· Three dimensional-conformal·Radiotherapy ,adjuvant 没有远处转移征象但不能完全切除的胰腺癌称为局部晚期胰腺癌，目前国外标准的治疗方案是放化学治疗联合治疗,但采用何种联合治疗形式、化学治疗方案及放射治疗计划还没有统一的认识。本研究采用替加氟联合顺铂化学疗法同时三维适形放射疗法治疗局部晚期胰腺癌患者共19例，报道如下。 1　资料与方法 1.1　一般资料　收集山东大学齐鲁医院肿瘤中心放疗科2003年4月—2005年1月局部晚期胰腺癌患者19例，男14例，女5例；年龄38～66岁，平均年龄56岁；其中胰头癌12例，胰体癌5例，胰尾癌2例；患者均有不同程度的腰腹痛