摘要
目的 通过不能手术胰腺癌单纯介入治疗、常规或三维适形放疗、常规或三维适形放疗＋介入治疗模式的预后分析,探讨最佳治疗模式.方法 回顾分析2003-2008年收治的139例局部晚期（Ⅲ期,82例）和转移性（Ⅳ期,57例）胰腺癌患者资料,其中胰头癌74例.3例患者穿刺病理诊断为导管腺癌,大多为CT、MRI超声等影像学结合临床症状和化验检查临床诊断.单纯介入治疗、常规或三维适形放疗、常规或三维适形放疗＋介入治疗分别为71、34、34例,比较3种治疗模式结果 并行单因素及Cox模型多因素分析.结果 随访率为92.1%,随访满1、2年者分别为115、98例.全组1和2年生存率分别为37.1%和16.3%,局部晚期胰腺癌的分别为44%和20%,单纯介入治疗、常规或三维适形放疗、常规或三维适形放疗＋介入治疗的分别为18%和5%、61%和29%、48%和25%（χ2=14.65,P=0.001）.全组胰腺癌预后单因素分析有意义因素为分期（χ2=4.49,P=0.035）、是否接受常规或三维适形放疗（χ2=15.32,P=0.000）、肿瘤原发部位（χ2=10.74,P=0.002）等,多因素分析有意义因素为肿瘤原发部位（χ2=5.00,P=0.025）、是否接受常规或三维适形放疗（χ2=7.93,P=0.005）.结论 对不能手术的局部晚期胰腺癌患者,常规或三维适形放疗是有效的治疗模式,而常规或三维适形＋介入治疗效果还需进一步研究.
Objective To analyze the results and prognosis for patients with inoperable pancreatic carcinoma treated by interventional chemotherapy （IC） ,three-dimensional radiotherapy （RT）, or IC ＋ RT.Methods From 2003 to 2008,139 patients with locally advanced （82 patients, stage Ⅲ） or metastatic （57 patients, stage Ⅳ） pancreatic cancer were retrospectively analyzed, including 74 with pancreatic head carcinoma （53.2%）.Three patients with ductal adenocarcinoma were diagnosed with fine-needle aspiration, all other patients were clinically diagnosed with imagings （CT, MRI and/or ultrasonosraphy）,clinical symptoms and tumor markers, There were 71,34 and 34 patients receiving IC alone, 3DCRT alone and 3DCRT plus IC, respectively.Log-rank univariate and Cox model multivariate analyses were used to determine prognostic factors.Results The follow-up rate was 92.1%.115 and 98 patients were followedup longer than 1 and 2 years, respectively.The 1-and 2-year overall survival rates were 37.1% and 16.3%for all patients, 44% and 20% for patients with locally advanced disease.The corresponding rates were 18% and 5%, 61% and 29% ,48% and 25% （χ2= 14.65,P=0.001） for patients receiving IC alone, RT alone, and IC ＋ RT, respectively.In univariate analysis, staging （χ2= 44.49, P = 0.035）, radiotherapy （χ2= 15.32, P = 0.000） and tumor location （χ2= 10.741, P = 0.002） were prognostic factors.In multivariate analysis, tumor location （χ2= 5.00, P = 0.025） and radiotherapy （χ2= 7.93, P = 0.005） were prognostic factors.Conclusions Radiotherapy can improve overall survival among patients with inoperable pancreatic cancer.The effect of RT ＋ IC should be further investigated.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2010年第5期445-447,共3页
Chinese Journal of Radiation Oncology
关键词
胰腺肿瘤/放射疗法
胰腺肿瘤/化学疗法
化学疗法
介入性
预后分析
Pancreatic neoplasms/radiotherapy
Pancreatic neoplasms/chemotherapy
Chemotherapy, interventional
Prognosis analysis
