摘要
目的观察射波刀联合替吉奥治疗局部晚期胰腺癌的疗效及安全性。方法将95例局部晚期胰腺癌患者分为两组：射波刀组（n=45）仅接受射波刀治疗,联合组（n=50）接受射波刀联合替吉奥单药化疗,射波刀治疗期间同步替吉奥化疗,结束3周后开始序贯化疗,共化疗4~6周期。观察疗效和不良反应,随访无进展生存时间（PFS）和总生存时间（OS）。结果射波刀治疗组和联合组客观有效率分别为75.6%、86.0%（P〈0.05）,疼痛缓解率分别为94.7%、95.2%（P〉0.05）。治疗后两组的总胆红素、CA19-9指标均较治疗前明显改善,差异均有统计学意义（P〈0.01）,但两组间差异均无统计学意义（P〉0.05）。中位随访时间20个月,两组中位PFS分别为10.1个月和11.2个月,中位OS分别为15.5个月和16.7个月（P〉0.05）。射波刀组和联合组患者的消化道反应发生率分别为48.9%和56.0%,骨髓抑制发生率分别为11.1%和20.0%（P〉0.05）,均未见3-4级严重不良反应。结论射波刀联合替吉奥治疗局部晚期胰腺癌可提高患者局部控制率和有效率,止痛作用强且起效快,并可延长PFS和OS,是一种安全有效的治疗模式。
EAbstract] Objective To evaluate the effect and toxicity of cyberknife therapy combined with titanium silicalite-1 （TS-1） in treatment of local advanced pancreatic cancer （LAPC）. Methods Ninety-five patients with LAPC were divided into two groups： cyberknife group （control group, n=45） received cyberknife therapy only, and combination group （n=50） received cyberknife therapy combined with TS-1. The adjuvant chemotherapy was performed 3 weeks after radiotherapy, and lasted for 4-6 cycles continuously. The effect, side effect, progression-free survival （PFS） and overall survival （OS） were recorded. Results In cyberknife group and combination group, the objective response rates （ORR, CR＋PR） were 75.6% and 86.0% （P〈0.05） respectively, the pain relief rates were 94.7% and 95.2% （P〉0.05） respectively. The indexes of total bilirubin and CA19-9 were significantly improved in the both groups after than before treatment with statistical significance （P〈0.01）, but there was no significant difference between the two groups （P〉0.05）. In the median follow-up time of Z0 months, the median PFS was 10.1 and 11.2 months and the median OS was 15.5 and 16.7 months in cyberknife and combination group, respectively （P〉0.05）. The incidences of digestive tract adverse reaction and myelosuppression in cyberknife group and combination group were 48.9% and 56.0%, 11.1% and 20.0%, respectively （P〉0.05）. There was no grade 3-4 serious adverse reaction. Conclusion Cyberknife combined with TS-I is effective and safe for patients with LAPC, may improve local control rate, effective rate, PFS and OS.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2016年第10期848-852,共5页
Medical Journal of Chinese People's Liberation Army
关键词
胰腺肿瘤
射波刀
替吉奥
pancreatic neoplasm
cyber knife
TS-1
