协和医学杂志

2013, (04)

[打印本页] [关闭]
本期目录(Current Issue) | 过刊浏览(Past Issue) | 高级检索(Advanced Search)

胰腺癌精确放疗的疗效及预后因素
Analysis of the prognostic factors of precise radiotherapy in pancreatic cancer

胡克

摘要(Abstract):

目的:分析胰腺癌的精确放疗疗效及预后因素。材料与方法:2003年-2012年期间102例接受精确放疗的胰腺癌患者,其中根治性放疗54例,辅助性放疗48例。三维适形放疗(3-DCR)16例,调强放疗(IMRT)86例,中位放疗剂量50Gy,1.8-2.2Gy/次。13例同步卡培他滨化疗。结果:总的中位总生存时间(OS)为14±1.2个月,中位无疾病进展时间(PFS)为9±1.1个月。1、2、5年生存率分别为63.3%、22.6%、10%。毒性反应包括3级消化道毒性5例,无3、4级血液学和4级消化道毒性反应。单因素分析结果表明,治疗前体重下降>5kg(p<0.0001)、T分期(p=0.011)、TNM分期(p=0.007)分期、是否行肿瘤切除术(p=0.001)是影响总生存时间的预后因素,同时也是无疾病进展时间的预后因素。多因素分析结果表明,肿瘤切除术是总生存期的预后因素(x2=5.416,p=0.02)。结论:在胰腺癌的根治性放疗和辅助性放疗中,三维适形放疗和调强放疗都可以较好的耐受,3、4级毒性反应较少,可以提高总的生存时间和无进展生存时间,为放化疗同步及肿瘤放疗剂量的提升提供了可行性。
Objective: to analyze the effect and prognostic factors of precise radiotherapy in pancreatic cancer. Materials and methods: 102 cases of patients with pancreatic cancer received precise radiotherapy btween 2003 and 2012 , radical radiotherapy in 54 cases and adjuvant radiotherapy in 48 cases. The median radiotherapy dose was 50Gy (1.8-2.2Gy/f) and three dimensional conformal radiotherapy(3-DCR) in 16 cases, intensity-modulated radiotherapy (IMRT) in 86 cases. Concurrent capecitabine chemotherapy was carried out in 13 cases of patients . Results: the median overall survival time (OS) and the median time to progression free survival (PFS) was 14 ± 1.2 months and 9 ± 1.1 months,respectively. 1, 2, 5 year survival rate was63.3%,22.6%,10%,respectively. Grade 3 gastrointestinal toxicity occurred in 5 cases of patients. No grade 3 or 4 hematologic toxicity and grade 4 gastrointestinal toxicity was observed. Univariate analysis showed that weight loss of > 5kg before treatment (P < 0.0001), T staging (p=0.011), TNM staging (p=0.007) and surgical excision (p=0.001) were the prognostic factors affecting OS and PFS . The results of multivariate analysis showed that surgical excision is a prognostic factor for OS (x2=5.416, p=0.02). Conclusion: three-dimensional conformal radiotherapy and intensity modulated radiotherapy can be tolerated with less grade 3 and 4 toxicity in pancreatic cancer patients treatment with radical radiotherapy and adjuvant radiotherapy. The precise radiotherapy can improve the overall survival and progression-free survival time,which can provided the feasibility for concurrent chemotherapy and radiotherapy dose increasing.

关键词(KeyWords): |胰腺癌|三维适形放疗|调强放疗|预后|
|Pancreatic cancer| Three-dimensional conformal radiotherapy| Intensity modulated radiation therapy| Prognosis|

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 胡克

Email:

DOI:

参考文献(References):

扩展功能
本文信息
服务与反馈
本文关键词相关文章
本文作者相关文章
中国知网
分享