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[目的]观察康莱特注射液(Kanglaite injection,KLT)联合体部伽玛刀对局部晚期胰腺癌的治疗效果。[方法]55例局部晚期胰腺癌患者随机分为两组,研究组28例:采用体部伽玛刀治疗,PTV覆盖95%以上临床靶体积(clinical target volume,CTV),等剂量曲线为50%~60%。肿瘤单次周边剂量3.0~4.5Gy,治疗9~12次,同时给予康莱特注射液200ml/d,21d为1个疗程,共2个疗程。对照组:单纯行体部伽玛刀治疗。3个月后评价疗效,通过KPS评分、体重及疼痛变化,观察生存质量改善情况。[结果]两组完全缓解率分别为28.6%(8/28)和18.5%(5/27);有效率分别为82.1%(23/28)和74.1%(20/27)。研究组Ⅲ级以上胃肠道反应发生率为3.5%(1/28),对照组为29.6%(8/27);研究组未发生Ⅲ级以上骨髓抑制(0/28),对照组为18.5%(5/27);研究组未发生Ⅲ级以上放射性肠炎(0/28),对照组为14.8%(4/27);研究组治疗前后KPS评分、体重增高及疼痛症状缓解明显高于对照组(P<0.05)。[结论]体部伽玛刀治疗局部晚期胰腺癌安全有效,可提高局控率和有效率。康莱特配合体部伽玛刀治疗胰腺癌可以减轻治疗过程中胃肠道反应,减少Ⅲ级以上骨髓抑制和Ⅲ级以上放射性肠炎的发生,减轻疼痛症状,改善患者的生存质量。
[Objective] To observe the therapeutic effect of Kanglaite injection (KLT) combined with gamma knife on locally advanced pancreatic cancer. [Method] 55 patients with locally advanced pancreatic cancer were randomly divided into two groups. The study group consisted of 28 patients. Body gamma knife treatment, PTV covered more than 95% of clinical target volume (CTV), and the isodose curve was 50 % ~ 60%. A single peripheral dose of tumor 3.0 ~ 4.5Gy, treatment of 9 to 12 times, given Kanglaite injection 200ml / d, 21d for a course of treatment, a total of 2 courses. Control group: simple line of body gamma knife treatment. After 3 months, the curative effect was evaluated. The changes of KPS, body weight and pain were observed to observe the quality of life improvement. [Results] The complete remission rates of the two groups were 28.6% (8/28) and 18.5% (5/27), respectively. The effective rates were 82.1% (23/28) and 74.1% (20/27), respectively. The gastrointestinal reaction rate was 3.5% (1/28) in group Ⅲ and 29.6% (8/27) in group Ⅲ. There was no grade Ⅲ or higher myelosuppression (0/28) in study group and 18.5 in control group % (5/27). There was no grade Ⅲ or higher radiation enteritis (0/28) in the study group and 14.8% (4/27) in the control group. The KPS scores, weight gain and pain relief in the study group before and after treatment were significantly higher than those in the control Group (P <0.05). [Conclusion] Body gamma knife treatment of locally advanced pancreatic cancer is safe and effective, which can improve the rate of local control and efficiency. Kanglaite with body gamma knife treatment of pancreatic cancer can reduce gastrointestinal reactions during treatment, reduce the grade above myelosuppression and grade Ⅲ radiation enteritis, reduce pain symptoms and improve the quality of life of patients.