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目的探讨伽玛刀联合GP方案化疗治疗局部进展期胰腺癌的疗效。方法 75例不能手术切除局部进展期胰腺癌(LAPC)患者随机分为2组:A组(伽玛刀+化疗组)39例,伽玛刀联合“GP方案”全身化疗,具体化疗方案同化疗组;B组(化疗组)36例,应用“GP方案”全身化疗,具体:吉西他滨注射液1 000 mg/m2d1,8+顺铂注射液75 mg/m2分d1-4应用,21d为1疗程。2组患者均按期完成4个周期化疗后进行疗效评价。患者治疗后1、2、3个月行增强CT扫描及CA199复查,以后为每3个月1次,共随访30个月。结果 A组临床受益率:B组临床受益率=84.62%:58.33%(χ2=6.414,P=0.011<0.05),2组中位生存期为13.00月:9.00月,平均生存时间A组为15.13个月:B组为12.15个月(P=0.035<0.05)。2组75例病人中均按计划顺利完成,无1例术后及化疗后出现胰漏、出血、脏器穿孔及Ⅳ度骨髓抑制等严重并发症。结论伽玛刀联合GP方案治疗局部进展期胰腺癌是一种新的有效且安全的治疗方案,值得进一步探讨。
Objective To investigate the efficacy of gamma knife combined with GP regimen in the treatment of locally advanced pancreatic cancer. Methods Seventy-five patients with unresectable locally advanced pancreatic cancer (LAPC) were randomly divided into two groups: group A (gamma knife + chemotherapy group), gamma knife combined with “GP regimen” and chemotherapy regimen 36 patients in group B (chemotherapy group) received chemotherapy with “GP regimen”, including gemcitabine injection 1000 mg / m2d1 and cisplatin 75 mg / m2 d1-4, 21d for a course of treatment. Two groups of patients completed on schedule according to the efficacy of four cycles of chemotherapy. The patients underwent enhanced CT scan and CA199 after 1, 2 and 3 months after treatment, once every 3 months for a total follow-up of 30 months. Results The clinical benefit rate in group A was 84.62% (58.33%) in group B (χ2 = 6.414, P = 0.011 <0.05). The mean survival time in group A was 13.00 Month: Group B was 12.15 months (P = 0.035 <0.05). Two groups of 75 patients were successfully completed according to plan, none of them had postoperative and postoperative chemotherapy complications such as pancreatic leakage, hemorrhage, organ perforation and grade Ⅳ myelosuppression. Conclusion Gamma Knife combined with GP regimen in the treatment of locally advanced pancreatic cancer is a new effective and safe treatment, which deserves further exploration.