摘要
目的 探讨立体定向体部放射治疗(SBRT)对胰腺癌术后复发患者生存期的影响.方法 回顾性分析2012年2月至2016年12月间海军军医大学附属长海医院放疗科接受SBRT的104例胰腺癌术后复发的患者资料,治疗的处方剂量为35~40 Gy/4~8 f.采用Kaplan-Meier法进行生存分析,通过Cox比例风险模型筛选影响患者生存期的相关因素.结果 患者的中位总生存期和疾病无进展生存期(PFS)分别为12.5(11.0 ~14.0)个月和7.3(6.0 ~8.7)个月,1年生存率和1年无进展生存率分别为55.8%和22.1%.多因素分析结果显示,肿瘤分期、生物效应剂量(BED10)、治疗后CA19-9水平下降程度、接受后续化疗是影响总生存期的相关因素;肿瘤分期、BED10、疼痛缓解程度、治疗后CA19-9水平下降程度是影响PFS的相关因素.结论 肿瘤分期早、治疗前CA19-9水平正常、疼痛程度轻的胰腺癌复发患者宜选择SBRT治疗,BED10 ≥60 Gy、放疗后续进行化疗可以延长患者生存期.
Objective To identify the effect of stereotactic body radiation therapy (SBRT) on the survival of patients with recurrent pancreatic cancer after surgery.Methods The data of 104 patients with recurrent pancreatic cancer after surgery who underwent SBRT in the Department of Radiation Oncology of Changhai Hospital,Navy Medical University from February 2012 to December 2016 were retrospectively analyzed.The prescription doses ranged from 35-40 Gy/4-8 f.Survival analysis was performed using the Kaplan-Meier method,and relevant factors affecting patients' survival were screened by the Cox proportional hazards model.Results The median overall survival (OS) and progression free survival (PFS) was 12.5 (11.0-14.0) months and 7.3 (6.0-8.7) months,respectively,while the 1-year rate of OS and PFS was 55.8% and 22.1%,respectively.Multivariate analysis indicated that tumor stage,biological effect dose (α/β =10,BED10),the decrease of CA19-9 level after treatment,and follow-up chemotherapy were all related factors affecting overall survival;tumor stage,BED10,the degree of pain relief and the decrease of CA19-9 level after treatment were related factors affecting PFS.Conclusions Patients suffering recurrent pancreatic cancer with early tumor stage,normal CA19-9 level and mild pain before treatment could be better treated by SBRT,BED10 ≥60 Gy and follow-up chemotherapy after radiotherapy can prolong the survival of patients.
作者
余海燕
朱晓斐
汤寅
赵宪芝
江林宫
耿杨杨
邱春燕
陈迪
居小萍
张火俊
Yu Haiyan;Zhu Xiaofei;Tang Yin;Zhao Xianzhi;Jiang Lingong;Geng Yangyang;Qiu Chunyan;Chen Di;Ju Xiaoping;Zhang Huojun(Department of Radiation Oncology,Changhai Hospital,Navy Medical University,Shanghai 200433,China)
出处
《中华胰腺病杂志》
CAS
2019年第1期30-33,共4页
Chinese Journal of Pancreatology
基金
中国健康促进基金会重点资助项目(THC2015001).
关键词
胰腺肿瘤
放射疗法
复发
治疗结果
Pancreatic neoplasms
Radiotherapy
Recurrence
Treatment outcome
