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[目的]观察三维适形放疗联合卡培他滨或吉西他滨治疗局部晚期胰腺癌的疗效及毒副反应。[方法]43例局部晚期胰腺癌患者非随机分为两组。A组:卡培他滨800mg/m2,2次/d,每周1~5d口服,联合同期三维适形放疗(DT45~50.4Gy/25~28次,1次/d,5次/周);B组:吉西他滨每周600mg/m2,每周1次,联合三维适形放疗(同A组)。观察两组的有效率、临床获益及毒副反应。[结果]A、B组有效率(37.5%vs42.1%)、临床获益率(75.0%vs73.6%)、中位生存时间(9.2个月vs10.7个月)、中位无进展生存时间(7.1个月vs7.9个月)以及1年生存率(33.3%vs36.8%)、2年生存率(8.3%vs10.5%)均无统计学差异。吉西他滨组骨髓抑制发生率明显高于卡培他滨组(P<0.05),虽然腹泻发生率在卡培他滨组明显更高,但均为Ⅰ/Ⅱ级,患者可耐受。[结论]卡培他滨联合同步放疗可取得较好的临床疗效,患者耐受性良好,其效果尚需临床进一步研究。
[Objective] To observe the curative effect and toxicity of three-dimensional conformal radiotherapy combined with capecitabine or gemcitabine in the treatment of locally advanced pancreatic cancer. [Method] Forty-three patients with locally advanced pancreatic cancer were randomly divided into two groups. Group A: capecitabine 800mg / m2, 2 times / d, 1 ~ 5d weekly oral, combined with three-dimensional conformal radiotherapy (DT45 ~ 50.4Gy / 25 ~ 28 times, Group B: Gemcitabine 600mg / m2 weekly, once a week, combined with three-dimensional conformal radiotherapy (with the A group). The two groups were observed the efficiency, clinical benefit and toxicity. [Results] The effective rate (37.5% vs 42.1%), the clinical benefit rate (75.0% vs 73.6%), the median survival time in group A and B (9.2 months vs10.7 months) The survival time (7.1 months vs 7.9 months) and 1-year survival rate (33.3% vs36.8%), 2-year survival rate (8.3% vs10.5%) had no statistical difference. The incidence of myelosuppression in gemcitabine group was significantly higher than that in capecitabine group (P <0.05). Although the incidence of diarrhea was significantly higher in capecitabine group, all were grade Ⅰ / Ⅱ patients were tolerated. [Conclusion] Capecitabine combined with concurrent radiotherapy can achieve better clinical efficacy, patients with good tolerance, the effect still need further clinical study.