摘要目的 评价立体定向放射治疗联合吉西他滨与吉西他滨单药治疗局部晚期胰腺癌的疗效.方法 治疗组56例胰腺癌行立体定向放疗联合吉西他滨单药化疗.对照组50例仅行吉西他滨单药化疗.立体定向放疗,总剂量4000～4500cGy,10次分割.同步化疗方案为吉西他滨500 mg/m2第1、8天.对照组给予输注吉西他滨1 000 mg/m2,第1、8、15天.结果 治疗结束2个月后CT复查,治疗组及对照组有效率分别为82％、16％,疼痛缓解率分别为67％、17％.疾病进展时间治疗组为14个月,优于对照组7.5个月,差异有统计学意义(x2=7.31,P=0.032).中位生存期治疗组和对照组分别为15.8个月及13.2个月,差异无统计学意义(x2=3.28,P=0.082).结论 立体定向放射治疗联合吉西他滨治疗局部晚期胰腺癌较单纯化疗组有效率、疼痛缓解率高；能延长疾病进展时间,但未能改善总生存期.

abstractsObjective To evaluate the efficacy of stereotactic body radiotherapy combined with coinstan taneous gemcitabine,and gemcitabine alone for advanced pancreatic cancer.Methods 56 advanced pancreatic cancer patients were assigned into observation group,which accepted stereotactic body radiotherapy combined with coinstantaneous gemcitabine 500 mg/m2,d1,d8.Other 50 patients were assigned into the control group which only accepted gemcitabine 1 000 mg/m2,d1,d8,d15.Stereotactic body radiotherapy was delivered with a total dose of 4 000-4 500 cGy in 10 fractions.Results CT examinations were carried out 2 months after treatment.The response rate of the observation group and control group was 82％ and 16％ respectively,and the pain relief rate was 67％ and 17％ respectively.The time to progression of the observation group was 14 months,and was better than that of the control group(7.5 months,x2 =7.31,P =0.032).The median survival time of the observation group and control group was 15.8 months and 13.2 months,and the difference had no statistical significance(x2 =3.28,P =0.082).Concolusion Stereotactic body radiotherapy combined with gemcitabine has a better overall response rate and a pain relief rate.It can prolong the time to progression,but can't improve the overall survival.