射波刀放疗剂量递增对局部晚期胰腺癌疗效的影响研究OA
Study on the Effect of Increasing Dose of Cyberknife Radiotherapy on the Therapeutic Effect of Locally Advanced Pancreatic Cancer
目的 探索射波刀放射治疗(简称"放疗")剂量递增对局部晚期胰腺癌疗效的影响.方法 选取联勤保障部队第九四医〇院肿瘤放射治疗中心2013年1月至2023年6月期间射波刀治疗局部晚期胰腺癌的110例患者为研究对象,根据放疗剂量分为3组:35、40、45 Gy.主要观察3组的中位生存期、生存率,次要观察3组的局部控制率及无远转生存率,分析3组间差异是否有统计学意义.结果 110例局部晚期胰腺癌患者的中位生存期为15个月,1年生存率为65.2%(95%CI:55.9%～76.2%),2年生存率为36.4%(95%CI:26.4%～50.4%).35、40、45 Gy 3组中位生存期分别为11、20和25个月,差异有统计学意义(x2=12.789,P=0.002<0.05).40 Gy组与35 Gy组相比,中位生存期明显延长,差异有统计学意义(20个月 vs.11个月,x2=7.070,P=0.008<0.05),而40 Gy组与45 Gy组之间差异无统计学意义(x2=0.744,P=0.388>0.05).35、40、45 Gy 3组的1年生存率分别为46.0%、64.9%和85.3%,1年的局部控制率分别为48.4%、55.4%和67.6%,1年的无远转生存率分别为57.4%、74.5%和52.3%.110例患者治疗前后的最大横截面面积和肿瘤标志物糖类抗原199差异均有统计学意义(P<0.05).110例患者的胃肠道毒性反应和骨髓毒性反应均主要为1～2级.结论 随着放疗剂量的递增,射波刀治疗局部晚期胰腺癌患者的中位生存期逐渐增加,达到一定剂量后不再随之增加;随着局部晚期胰腺癌患者放疗总剂量的增加,局部控制率增加,但差异无统计学意义.
Objective To explore the effect of dose escalation of Cyberknife radiotherapy(referred to as"radiotherapy")on the therapeutic effect of locally advanced pancreatic cancer.Methods A total of 110 patients with locally advanced pancreatic cancer treated with Cyberknife at the Department of Radiotherapy of the 940th Hospital of Joint Logistic Support Force of PLA from January 2013 to June 2023 were selected as the research subjects and divided into 3 groups according to the radiotherapy dose:35,40,and 45 Gy.The median survival period and survival rate of the three groups were mainly observed.The local control rate and distant survival rate of the three groups were secondiously observed.The differences among the three groups were analyzed to see if they were statistically significant.Results The median survival time of 110 patients with locally advanced pancreatic cancer was 15 months.The 1-year survival rate was 65.2%(95%CI:55.9%-76.2%),and the 2-year survival rate was 36.4%(95%CI:26.4%-50.4%).The median survival periods of the 35,40,and 45 Gy groups were 11,20,and 25 months respectively,and the difference was statistically significant(x2=12.789,P=0.002<0.05).Compared with the 35 Gy group,the median survival time of the 40 Gy group was significantly prolonged,and the difference was statistically significant(20 months vs.11 months,x2=7.070,P=0.008<0.05),while there was no statistically significant difference between the 40 Gy group and the 45 Gy group(x2=0.744).P=0.388>0.05.The 1-year survival rates of the 35,40,and 45 Gy groups were 46.0%,64.9%,and 85.3%respectively;the 1-year local control rates were 48.4%,55.4%,and 67.6%respectively;and the 1-year distant transfer-free survival rates were 57.4%,74.5%,and 52.3%respectively.The differences in the maximum cross-sectional area and the tumor marker carbohydrate antigen 199 before and after treatment in 110 patients were statistically significant(P<0.05).The gastrointestinal toxic reactions and bone marrow toxic reactions of 110 patients were mainly grade 1 to 2.Conclusion With the increase of radiotherapy dose,the median survival time of patients with locally advanced pancreatic cancer treated with Cyberknife will gradually increase and will no longer increase after reaching a certain dose.With the increase of the total radiotherapy dose for patients with locally advanced pancreatic cancer,the local control rate will also increase,but the difference is not statistically significant.
张效亮;田种泽;朱向辉;刘晓娇;马小婷;张超
中国人民解放军联勤保障部队第九四〇医院 放疗治疗科,甘肃 兰州 730050中国人民解放军联勤保障部队第九四〇医院 放疗治疗科,甘肃 兰州 730050中国人民解放军联勤保障部队第九四〇医院 放疗治疗科,甘肃 兰州 730050中国人民解放军联勤保障部队第九四〇医院 放疗治疗科,甘肃 兰州 730050中国人民解放军联勤保障部队第九四〇医院 放疗治疗科,甘肃 兰州 730050中国人民解放军联勤保障部队第九四〇医院 放疗治疗科,甘肃 兰州 730050
医药卫生
胰腺癌射波刀放疗剂量生存率局部控制率无远转生存率
pancreatic cancerCyberkniferadiotherapy doseoverall survivallocal control ratedistant metastasis-free survival
《中国医疗设备》 2025 (7)
33-39,7
甘肃省自然科学基金(22JR5RA003).
评论