胰腺癌后程加量三维适形放射的疗效分析

王伟1，任宏2，王斌3 *

（1.子洲县中医院普外科，陕西 榆林，718499；2. 西安交通大学医学院第一附属医院肿瘤外科，陕西 西安，710061； 3.榆林市星元医院普外科，陕西 西安，719000）

浏览次数：131次 下载次数：302次

摘要：

目的 探讨后程加量三维适形放射（3DCRT）治疗胰腺癌的临床疗效。方法 选取2011 年2 月至2016 年2 月我院收治的 56 例胰腺癌患者，均采用3DCRT 治疗，观察患者临床治疗效果。结果患者采用3DCRT 治疗后，RR 患者23 例（41.07%）。在56 例 患者中，治疗前45 例患者血清CA19-9 水平>37 U/mL，而且其中20 例患者血清CA19-9 水平>1 000 U/mL，26 例患者的CA19-
9 水平为（379.8±106.9）U/mL；治疗3 个月后，在26 例患者中有25 例CA19-9 水平为（82.8±30.5）U/mL；治疗前、后患者的血清 CA19-9 水平比较，差异显著（P<0.05）。发生Ⅰ级上消化道反应的患者为25 例（44.64%），发生域级上消化道反应的患者为6 例 （10.71%），对患者实施胃复安、恩丹司酮等对症治疗，有效缓解。放疗后胰腺癌患者1、2、3 年生存率分别为73.21%、28.57%、19.64%。结论 3DCRT 治疗胰腺癌具有较为良好的近期、远期效果，可有效降低CA19-9 水平，不良反应少，临床应用价值高。

关键词：胰腺癌；CA19-9；三维适形放疗

中图分类号：R735.9文献标志码：A文章编号：2096-1413(2018)01-0038-02

Curative effect of three-dimensional conformal radiotherapy with increasing dose on pancreatic cancer
WANG Wei 1, REN Hong2, WANG Bin 3 *
(1. General Surgery Department, the Hospital of Zizhou County, Yulin 718499; 2. Oncology Department, the First Affiliated Hospital of Xi``an Jiaotong University Medical School, Xi``an 710061; 3. General Surgery Department,Xingyuan Hospital, Yulin 719000, China)

ABSTRACT: Objective To investigate the curative effect of three-dimensional conformal radiotherapy with increasing dose (3DCRT) on pancreatic cancer. Methods From February 2011 to February 2016, 56 cases of pancreatic cancer patients used 3DCRT, the curative effect of the patients were observed. Results After treatment with 3DCRT, 23 patients (41.07%) had RR. Of the 56 patients, the serum CA19-9 levels in the 45 patients before treatment were >37 U/mL, and 20 cases of patients with CA19-9 level >1 000 U/mL, the level of CA19-9 in 26 patients was (379.8±106.9) U/mL, After 3 months of treatment, the CA19-9 in 25 cases of 26 patients was (82.8±30.5) U/mL, the serum CA19-9 levels were significantly different between before and after treatment (P<0.05). There were 25 cases (44.64%) in grade Ⅰ upper gastrointestinal tract reaction, 6 cases (10.71%) in grade Ⅱ upper gastrointestinal tract, and the patients were treated with metoclopramide and ondansetron and eased effectively. After radiotherapy, the annual survival rates of patients with pancreatic cancer 1, 2 and 3 were 73.21%, 28.57% and 19.64% respectively. Conclusion 3DCRT has good near-term, long-term effect in the treatment of pancreatic cancer, which can effectively reduce the level of CA19-9, with few adverse reactions, and the clinical value is high.
KEYWORDS: pancreatic carcinoma; CA19-9; three-dimensional conformal radiotherapy

参考文献：
[1] 姚彪,徐润,商妮娅,等.三维适形放射治疗鼻咽癌的临床观察[J].中国现代医生,2015,53(16):42-44.
[2] 和劲光.替吉奥及吉西他滨分别联合奈达铂同步三维适形放射治疗Ⅲ期非小细胞肺癌的效果比较[J].中国综合临床,2016,56(13):78-80.
[3] 何文志.用三维适形放射疗法和替莫唑胺对恶性脑胶质瘤患者进行治疗的效果观察[J].当代医药论丛,2016,14(22):131-132.
[4] 周绍兵,丁文秀,郭信伟,等.食管癌术后纵隔淋巴结转移中部分群体同步放化疗的疗效观察[J].临床肿瘤学杂志,2016,21(11):1001-1004.
[5] 赵一虹,许卫东,张富利.TOMOX 方案联合三维适形放射治疗中晚期食管癌的近期疗效及不良反应观察[J].中国医学装备,2016,13(10):61-64.
[6] 张爱灵,王维.常规分割与大分割三维适形放射治疗非小细胞肺癌合并上腔静脉压迫综合征[J].昆明医科大学学报,2016,37(6):77-81.
[7] 王红亚.三维适形放射对胰腺癌的近期疗效观察[J].当代医学,2016,22(20):65-66.