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目的评估高剂量少分次放疗模式治疗老年Ⅳ期胰腺癌的疗效及毒副反应。方法收集2011年9月-2015年5月于中国人民解放军空军总医院肿瘤放疗科就诊的胰腺癌伴远处转移患者的临床资料,所有患者接受螺旋断层放疗高剂量少分次模式治疗。通过随访获取疗效及毒副反应,依据NCI-CTCAE 4.02标准行不良反应评价。生存分析采用Kaplan-Meier法。结果共33例65岁以上患者接受高剂量少分次模式放疗,30例获得随访,获访率91.0%,其中位生存时间9个月,1年生存率为24.0%,疼痛缓解率80.0%(20/25)。17例患者可评价胰腺病灶治疗效果,其中部分缓解4例(23.5%),稳定12例(70.6%),进展1例(5.9%)。毒副反应中血液学反应3级占6.7%(2/30),无2级以上消化道反应。结论采用高剂量少分次模式治疗老年Ⅳ期胰腺癌,副反应可接受,可缓解患者癌痛,有延长生存时间的趋势。
Objective To evaluate the efficacy and side effects of high dose and fractionated radiotherapy in the treatment of advanced stage Ⅳ pancreatic cancer. Methods The clinical data of patients with distant metastasis of pancreatic cancer who were treated in the Department of Radiation Oncology, PLA General Hospital of Chinese PLA from September 2011 to May 2015 were collected. All patients were treated with high-dose and low-dose helical CT. Through follow-up for efficacy and toxicity, according to NCI-CTCAE 4.02 standard adverse reaction evaluation. Survival analysis using Kaplan-Meier method. Results A total of 33 patients over the age of 65 were treated with high dose and fractional radiation. 30 patients were followed up for 91.0% of the patients. The median survival time was 9 months. The 1-year survival rate was 24.0% and the pain relief rate was 80.0% 20/25). Seventeen patients were evaluated for the therapeutic effect of pancreatic lesions. Among them, partial response was achieved in 4 patients (23.5%), stable in 12 patients (70.6%), and progression in 1 patient (5.9%). Toxicity in hematological reactions 3 accounted for 6.7% (2/30), no more than 2 gastrointestinal reactions. Conclusions High-dose and less-divided treatment of elderly patients with stage Ⅳ pancreatic cancer, side effects acceptable to patients with cancer pain relief, there is a tendency to extend the survival time.