论文部分内容阅读
目的观察吉西他滨固定剂量率(fixed dose rate,FDR)输注联合体部伽玛刀治疗中晚期胰腺癌的效果。方法选择2006年1月—2010年1月收治的中晚期胰腺癌患者58例,采用OUR-QGD型立体定向体部伽玛刀治疗系统进行放疗,首程化疗与放疗同步,吉西他滨500 mg/m2,以10 mg·m-2·min-1速度输注50 min,放疗开始的第1、8天给药。放疗结束后3周开始序贯化疗,吉西他滨1 000 mg/m2,以10 mg·m-2·min-1速度输注100 min,第1、8天给药。21 d为1个周期,序贯化疗3个周期。治疗后2个月评价近期疗效,观察黄疸消退及CA199下降情况,随访观察生存率、临床受益反应(clinical benefit response,CBR)、不良反应。结果 58例治疗2个月后总有效率81.0%。18例白陶土大便患者全部恢复正常,31例梗阻性黄疸患者中27例明显缓解,缓解率87.1%,14例患者血清总胆红素下降至正常,22例CA199升高患者降至正常。1年生存率67.2%,2年生存率29.3%,3年生存率5.2%。临床受益率为96.6%。Ⅰ、Ⅱ级不良反应45例,Ⅲ级不良反应13例。放射反应主要为急性胃肠道反应12例,经对症治疗后缓解。结论吉西他滨FDR输注联合体部伽玛刀治疗中晚期胰腺癌近期效果好,不良反应较小,是治疗中晚期胰腺癌的有效方法。
Objective To observe the effect of gemcitabine fixed dose rate (FDR) infusion combined with gamma knife in the treatment of advanced pancreatic cancer. Methods Fifty-eight patients with advanced pancreatic cancer who were admitted to our hospital from January 2006 to January 2010 were treated with OUR-QGD Gamma knife radiosurgery. The first course of chemotherapy and radiotherapy were synchronized. Gemcitabine 500 mg / m2 , The infusion rate of 10 mg · m-2 · min-1 for 50 min, on the first and eighth days of radiotherapy. Chemotherapy was started 3 weeks after the end of radiotherapy. Gemcitabine was administered at 1 000 mg / m2 for 10 min at a dose of 10 mg · m-2 · min-1 and administered on days 1 and 8. 21 d for a cycle, sequential chemotherapy 3 cycles. Two months after treatment, the curative effect was evaluated. The regression of jaundice and the decrease of CA199 were observed. Survival rate, clinical benefit response (CBR) and adverse reactions were observed. Results 58 cases of 2 months after treatment, the total effective rate was 81.0%. 18 cases of white clay stool patients returned to normal, 31 cases of obstructive jaundice in 27 patients were significantly relieved, the response rate was 87.1%, 14 patients serum total bilirubin decreased to normal, 22 patients with elevated CA199 dropped to normal. The 1-year survival rate was 67.2%, the 2-year survival rate was 29.3%, and the 3-year survival rate was 5.2%. The clinical benefit rate was 96.6%. There were 45 cases of grade Ⅰ and Ⅱ adverse reactions and 13 cases of grade Ⅲ adverse reactions. Radiation reaction was mainly acute gastrointestinal reaction in 12 cases, after symptomatic treatment relief. Conclusion The gemcitabine FDR infusion combined with gamma knife treatment of advanced pancreatic cancer with short-term effect, less adverse reactions, is an effective method for the treatment of advanced pancreatic cancer.