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目的探讨三维X线适型放疗联合吉西他滨(GEM)化疗治疗中、晚期胰腺癌的疗效。方法选择我院确诊为中、晚期胰腺癌患者100例,随机分为观察组和对照组各50例,两组患者每周第1d给予GEM 1000mg/m~2,第1～5d给予5-氟尿嘧啶(5-Fu)500mg/m~2+四氢叶酸钙(CF)200mg/m~2静脉滴注,每3周为1个周期,给药3个周期。观察组化疗第1d即开始行三维适型放疗,观察两组患者的临床疗效、不良反应及生存率。结果两组患者临床疗效间差异有非常显著性意义(P＜0．01)。两组患者疼痛完全缓解率、镇痛药物停用率间差异有显著性意义(P＜0．05)。两组患者术后6个月、12个月生存率及中位生存期间差异亦有显著性意义(P＜0．05)。两组患者白细胞计数下降、血小板计数(PLT)下降、腹泻、恶心呕吐、神经毒性及发热等不良反应发生率间差异均无显著性意义(P＞Q．05)。结论三维X线适型放疗联合GEM化疗治疗中、晚期胰腺癌,能控制肿瘤生长,缓解疼痛,改善患者生活质量,是一种安全、有效的肿瘤综合治疗手段。
Objective To investigate the efficacy of three-dimensional X-ray conformal radiotherapy combined with gemcitabine (GEM) chemotherapy in the treatment of advanced pancreatic cancer. Methods One hundred cases with pancreatic cancer diagnosed in our hospital were randomly divided into observation group and control group with 50 cases each. GEM 1000mg/m~2 was given on the first week of the two groups, and 5-fluorouracil was given on the first 1-5 days. (5-Fu) 500 mg/m~2+ calcium tetrahydrofolate (CF) 200 mg/m~2 was infused intravenously every 3 weeks for 3 cycles. Three-dimensional conformal radiotherapy was started on the first day of chemotherapy in observation group, and the clinical efficacy, adverse reactions and survival rate of the two groups were observed. Results There was a significant difference between the clinical efficacy of the two groups (P<0.01). There was a significant difference between the complete remission rate of pain and the discontinuation rate of analgesic drugs between the two groups (P<0.05). There was also significant difference in survival rate and median survival period between the two groups at 6 months and 12 months (P<0.05). There was no significant difference in the incidence of adverse events such as decreased white blood cell count, platelet count (PLT), diarrhea, nausea and vomiting, neurotoxicity and fever between the two groups (P>Q.05). Conclusion Three-dimensional X-ray conformal radiotherapy combined with GEM chemotherapy for the treatment of advanced and advanced pancreatic cancer can control tumor growth, relieve pain, and improve the quality of life of patients. It is a safe and effective method for comprehensive tumor treatment.