调强放疗联合卡培他滨同步化疗及HIFU治疗非手术老年胰腺癌患者疗效观察

发布时间：2019-02-14 13:06

【摘要】：目的探讨调强放疗(intensity modulated radiotherapy,IMRT)联合口服卡培他滨同步化疗及高强度聚焦超声(high intensity focused ultrasound,HIFU)治疗非手术老年胰腺癌患者的疗效及不良反应。方法患者60例随机分为对照组和观察组,各30例。对照组行IMRT联合口服卡培他滨同步化疗,于放疗第1天开始给予卡培他滨800~1 000 mg/m~2早晚饭后各口服一次,连续用药14天,休息7天行下一周期化疗,放疗结束后巩固化疗2~4周期。观察组行IMRT联合口服卡培他滨同步化疗及HIFU治疗,化疗方案同对照组,HIFU于放疗第1天开始,5次/周,连用4~6周。结果对照组和观察组治疗前后疼痛评分比较差异有统计学意义(P=0.001,P0.0001);两组间治疗前后疼痛减轻程度比较,差异有统计学意义(P=0.0162)。对照组和观察组的近期疗效组间比较,差异有统计学意义(Z=-2.159,P=0.031)。对照组和观察组在总生存率、无进展生存率、骨髓抑制、急性放射性肝损伤、急性放射性胃肠道损伤及急性放射性肾脏损伤不良反应发生率以及两组失败模式等方面比较,差异无统计学意义(P0.05)。结论 IMRT联合卡培他滨同步化疗及HIFU治疗老年非手术胰腺癌可缓解患者疼痛,提高生活质量,近期疗效确切,但未延长患者长期生存。
[Abstract]:Objective to investigate the efficacy and side effects of intensity modulated radiotherapy (intensity modulated radiotherapy,IMRT) combined with oral capecitabine combined with high intensity focused ultrasound (high intensity focused ultrasound,HIFU) in the treatment of non-operative elderly patients with pancreatic cancer. Methods 60 patients were randomly divided into control group and observation group with 30 cases each. The control group was treated with IMRT combined with oral capecitabine chemotherapy. On the first day of radiotherapy, capecitabine 800000 mg/m~2 was given orally once in the morning and evening after meals. After radiotherapy, 2 cycles of chemotherapy were consolidated. The observation group was treated with IMRT combined with oral capecitabine chemotherapy and HIFU. The chemotherapy regimen was the same as that of the control group. HIFU was used for 4 weeks at the first day of radiotherapy, 5 times a week. Results there was significant difference in pain score between control group and observation group before and after treatment (P0. 001), and there was significant difference in pain relief between two groups before and after treatment (P0. 0162). There was a significant difference between the control group and the observation group in the short term curative effect (Z-2. 159 P 0. 031). The overall survival rate, progression-free survival rate, bone marrow suppression, acute radiation liver injury, the incidence of adverse reactions of acute radiation gastrointestinal injury and acute radiation renal injury and the failure mode of the two groups were compared between the control group and the observation group. The difference was not statistically significant (P0.05). Conclusion IMRT combined with capecitabine chemotherapy and HIFU can relieve pain and improve quality of life in elderly patients with non-operative pancreatic cancer. The short-term curative effect is definite, but the long-term survival of the patients is not prolonged.
【作者单位】：湖北医药学院附属人民医院肿瘤中心;湖北医药学院附属人民医院超声科;
【基金】：湖北省教育厅科学研究计划指导性项目(B2015471);湖北省教育厅优秀中青年科技创新优秀团队项目(T201510) 十堰市科学技术研究与开发项目(16Y46);十堰市科学技术研究与开发项目(14Y36) 十堰市人民医院青年英才项目(14-7)
【分类号】：R735.9

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