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Stereotactic radiotherapy in 206 patients with pancreatic carcinoma
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摘要: 采用立体定向伽玛射线全身治疗系统治疗206例胰腺癌（PC）患者。根据肿瘤的位置、临床靶体积、患者的身体状况与治疗目的,制定放射治疗计划及调整剂量分布。等剂量曲线55%90%,周边照射总剂量（3000-4000）cGy,分割处方剂量（400-550）cGy,重复治疗6-8次,隔日治疗,治疗结束后3至12个月,中位随诊时间6、12个月。79例治疗前梗阻性黄疸者,消退55例（69.6%）。146例患者治疗前伴腹背部疼痛,完全消失91例（62.3%）,疼痛缓解42例（28.8%）。122例复查CT或MRI,肿瘤消失29例（23.8%）,缩小70例（57.4%）,无变化14例（11.5%）,增大9例（7.4%）。治疗3个月后在治疗部位复发者6例。75例治疗期间出现轻度副反应,但可继续完成治疗。死亡63例（30.6%）。立体定向放射治疗PC对周围组织器官伤害轻微,具有定位精确、治疗时间短、副作用小的特点,近期疗效较为满意。Abstract: Therapy of 206 patients with pancreatic carcinoma (PC) with Stereotactic Gamma Ray Whole Body Therapeutic System.To work out radiotherapeutic plan and set dosage distribution on the basis of the carcinoma position, clinical target volume, patient health condition, and therapeutic aim.The isodosage curve was (55-90) %.The peripheral radiation total dosage was (3000-4000) cGy and the fractional dosage was (400-550) cGy.The therapy had been repeated for 6-8 times, two days per time.The mean-time of follow up was 6.12 months.After the therapy 3 to 12 months 55 patients (69.6%) recovered from theirs obstructive jaundice among 79 patients.In 146 patients with dorsoventral pain before the therapy.91 patients (62.3%) got complete recover, 42 (28.8%) got remission, The analgesic effective rate was 91.1%.122 patients received CT, or MRI test The carcinoma disappeared in 29 (23.8%) patients, shrank in 70 (57.4%) , no varied in 14 (11.5%) , and augmented 69 (7.4%) .There was no evidence to confirm any relapse within therapeutic field.75 patients had mild side reaction, but could continue and complete the therapy.63 (30.6%) patients died from other causes. There is only mild damage on surrounding tissue and organs on the therapy of PC with stereotatic radiotherapy, which has accurate localization, short period of therapeutic time, and mild side reaction.The short term therapeutic effectiveness of PC with stereotatic radiotherapy is satisfactory.
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