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调强放疗联合卡培他滨同步化疗及HIFU治疗非手术老年胰腺癌患者疗效观察

许涛, 景红霞, 李林均, 张军, 余建云, 程雄飞, 焦娇

许涛, 景红霞, 李林均, 张军, 余建云, 程雄飞, 焦娇. 调强放疗联合卡培他滨同步化疗及HIFU治疗非手术老年胰腺癌患者疗效观察[J]. 肿瘤防治研究, 2017, 44(1): 48-52. DOI: 10.3971/j.issn.1000-8578.2017.01.010
引用本文: 许涛, 景红霞, 李林均, 张军, 余建云, 程雄飞, 焦娇. 调强放疗联合卡培他滨同步化疗及HIFU治疗非手术老年胰腺癌患者疗效观察[J]. 肿瘤防治研究, 2017, 44(1): 48-52. DOI: 10.3971/j.issn.1000-8578.2017.01.010
XU Tao, JING Hongxia, LI Linjun, ZHANG Jun, YU Jianyun, CHENG Xiongfei, JIAO Jiao. Efficacy of IMRT Combined with Capecitabine Concurrent Chemotherapy and High Intensity Focused Ultrasound for Elderly Patients with Non-operatable Pancreatic Cancer[J]. Cancer Research on Prevention and Treatment, 2017, 44(1): 48-52. DOI: 10.3971/j.issn.1000-8578.2017.01.010
Citation: XU Tao, JING Hongxia, LI Linjun, ZHANG Jun, YU Jianyun, CHENG Xiongfei, JIAO Jiao. Efficacy of IMRT Combined with Capecitabine Concurrent Chemotherapy and High Intensity Focused Ultrasound for Elderly Patients with Non-operatable Pancreatic Cancer[J]. Cancer Research on Prevention and Treatment, 2017, 44(1): 48-52. DOI: 10.3971/j.issn.1000-8578.2017.01.010

调强放疗联合卡培他滨同步化疗及HIFU治疗非手术老年胰腺癌患者疗效观察

基金项目: 

湖北省教育厅科学研究计划指导性项目 B2015471

湖北省教育厅优秀中青年科技创新优秀团队项目 T201510

十堰市科学技术研究与开发项目 16Y46

十堰市科学技术研究与开发项目 14Y36

十堰市人民医院青年英才项目 14-7

详细信息
    作者简介:

    许涛(1979-),男,硕士,副主任医师,主要从事肿瘤放射治疗工作

    通讯作者:

    景红霞,E-mail: jinghongxia@sina.com

  • 中图分类号: R735.9

Efficacy of IMRT Combined with Capecitabine Concurrent Chemotherapy and High Intensity Focused Ultrasound for Elderly Patients with Non-operatable Pancreatic Cancer

More Information
  • 摘要:
    目的 

    探讨调强放疗(intensity modulated radiotherapy, IMRT)联合口服卡培他滨同步化疗及高强度聚焦超声(high intensity focused ultrasound, HIFU)治疗非手术老年胰腺癌患者的疗效及不良反应。

    方法 

    患者60例随机分为对照组和观察组,各30例。对照组行IMRT联合口服卡培他滨同步化疗,于放疗第1天开始给予卡培他滨800~1 000 mg/m2早晚饭后各口服一次,连续用药14天,休息7天行下一周期化疗,放疗结束后巩固化疗2~4周期。观察组行IMRT联合口服卡培他滨同步化疗及HIFU治疗,化疗方案同对照组,HIFU于放疗第1天开始,5次/周,连用4~6周。

    结果 

    对照组和观察组治疗前后疼痛评分比较差异有统计学意义(P=0.001, P < 0.0001);两组间治疗前后疼痛减轻程度比较,差异有统计学意义(P=0.0162)。对照组和观察组的近期疗效组间比较,差异有统计学意义(Z=-2.159,P=0.031)。对照组和观察组在总生存率、无进展生存率、骨髓抑制、急性放射性肝损伤、急性放射性胃肠道损伤及急性放射性肾脏损伤不良反应发生率以及两组失败模式等方面比较,差异无统计学意义(P>0.05)。

    结论 

    IMRT联合卡培他滨同步化疗及HIFU治疗老年非手术胰腺癌可缓解患者疼痛,提高生活质量,近期疗效确切,但未延长患者长期生存。

     

    Abstract:
    Objective 

    To explore the clinical efficacy and toxicity of intensity modulated radiotherapy (IMRT) combined with oral capecitabine concurrent chemotherapy and HIFU for elderly patients with nonoperatable pancreatic cancer.

    Methods 

    Total 60 elderly patients with non-operatable pancreatic cancer were randomly divided into two group, 30 patients in control group received concurrent radiochemotherapy (intensity modulated radiation therapy (IMRT) with 6 MV X-ray and concurrently oral capecitabine (800-1 000 mg/m2, bid, d1-14, 21 days/cycle, concurrent chemotherapy for two cycles, consolidate chemotherapy for 2-4cycles)), and 30 patients in observation group received same concurrent radiochemotherapy and HIFU carried out concurrently with IMRT (5 days/week, 4-6 weeks).

    Results 

    There was significant difference of pain relief score in both control and observation group before and after treatment (P=0.001, P < 0.0001); the degree of pain releif in the observation group was more than that in the control group (P=0.0162). The difference of the short-term effects between two groups was statistical (Z=-2.159, P=0.031). The over survival, progression-free survival, failure patterns and adverse effects, such as myelosuppression, radiation-induced liver disease, radiationinduced gastrointestinal disease and radiation-induced kidney disease, were not statistically different between two groups (P>0.05).

    Conclusion 

    IMRT combined with capecitabine concurrent chemotherapy and HIFU for elderly patients with non-operatable pancreatic cancer are safe and effective in relieving pain and improving the quality of life, but there isn't advantage in longer overall survival or longer progression-free survival.

     

  • 图  1   两组胰腺癌患者总生存率的比较

    Figure  1   Comparison of 1-, 2-year overall survival rates between two groups in pancreatic cancer patients

    图  2   两组胰腺癌患者进展生存率的比较

    Figure  2   Comparison of 1-year progression-free survival rate between two groups in pancreatic cancer patients

    表  1   60例胰腺癌患者临床资料

    Table  1   Clinical data of 60 elderly patients with pancreatic cancer

    下载: 导出CSV

    表  2   两组胰腺癌患者近期疗效比较(n(%))

    Table  2   Comparison of short-term effects between two groups in pancreatic cancer patients (n(%))

    下载: 导出CSV

    表  3   两组胰腺癌患者不良反应比较(n(%))

    Table  3   Comparison of side effects between two groups in pancreatic cancer patents (n(%))

    下载: 导出CSV
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出版历程
  • 收稿日期:  2015-12-21
  • 修回日期:  2016-07-30
  • 网络出版日期:  2024-01-12
  • 刊出日期:  2017-01-24

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