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目的观察评价体部γ-刀治疗中晚期胰腺癌的疗效和放射反应。方法对52例Ⅱ～Ⅳ期胰腺癌采用体部γ-刀治疗,治疗时采用体架和真空负压袋固定体位,CT 扫描和三维计划,PTV在 GTV 外扩1cm,50%剂量线为处方剂量线,胰头癌3～4Gy/次,胰体尾癌4～5Gy/次,5次/周,肿瘤边缘总剂量40～51Gy,肿瘤中心区域80～102Gy。结果原发灶的完全缓解率(CR)19.2%,部分缓解率(PR)69.2%,总有效率(CR+PR)88.4%。Ⅱ～Ⅳ期1、2年总生存率分别为56.5%和23.1%。Ⅱ期1、2年生存率分别为76.9%和46.7%;Ⅱ期和Ⅲ～Ⅳ期的2年生存率间的差异有显著性意义。治疗期间胃肠反应 RTOG Ⅰ～Ⅱ级为57.3%,Ⅲ级5%,经对症处理病人均能按计划完成治疗。结论体部γ-刀治疗胰腺癌采用3～5Gy/次,5次/周,肿瘤边缘50%剂量线处总剂量45～51Gy 的治疗模式是安全有效的,对不能手术的局部晚期可提高局控率和生存率。
Objective To evaluate the efficacy and radiation response of gamma-knife in the treatment of advanced pancreatic cancer. Methods 52 cases of stage II-IV pancreatic cancer were treated with gamma-knife in the body. Body frames and vacuum negative pressure bags were used for the treatment. CT scanning and three-dimensional planning were performed. PTV was expanded 1 cm outside the GTV, and the 50% dose line was the prescription. Dose line, pancreatic head cancer 3 ~ 4Gy / times, pancreatic body and tail cancer 4 ~ 5Gy / times, 5 times / week, the total dose of tumor edge 40 ~ 51Gy, tumor center area 80 ~ 102Gy. Results The complete remission rate (CR) of the primary tumor was 19.2%, the partial remission rate (PR) was 69.2%, and the total effective rate (CR+PR) was 88.4%. The overall survival rate of patients at stage 1 to 2 was 56.5% and 23.1%, respectively. The 1-year and 2-year survival rates were 76.9% and 46.7%, respectively; there was a significant difference between the 2-year survival rates of phase II and III-IV. During the treatment, the gastrointestinal response RTOG I-II was 57.3% and III was 5%. All the patients who were symptomatic treatment could complete the treatment according to plan. Conclusion The use of gamma-knife to treat pancreatic cancer in the body with 3 to 5 Gy/time, 5 times/week, the total dose of 45 to 51 Gy at the edge of the tumor at the edge of the tumor is safe and effective, and the locally advanced stage can not be improved. Control rate and survival rate.