2019 年第 11 期 第 14 卷

伽马刀联合吉西他滨化疗对胰腺癌肝转移患者的近期疗效

Short-term effect of gamma knife radiosurgery combined with gemcitabine chemotherapy on liver metastasis of pancreatic cancer

作者：刘演高世乐

英文作者：

单位：230031合肥，中国人民解放军联勤保障部队第九〇一医院肿瘤四科

英文单位：

关键词：胰腺癌；肝转移；伽马刀；吉西他滨；近期疗效

英文关键词：

• 摘要：

• 【摘要】目的    探究伽马刀联合吉西他滨化疗对胰腺癌肝转移患者的近期疗效。方法    选取2008 年3月至 2017 年3月中国人民解放军联勤保障部队第九〇一医院收治的76例胰腺癌肝转移患者，按照随机数字分组法分为对照组（36例）和观察组（40例）。对照组仅接受吉西他滨化疗2个周期，观察组给予伽马刀联合吉西他滨同步放化疗，化疗方案同对照组。比较2组患者近期疗效、疼痛控制情况、总胆红素及血清肿瘤标志物糖类抗原199水平、生活质量改变及不良反应发生情况，并随访生存情况。结果    观察组患者临床获益率高于对照组［95.0%（38/40）比77.8%（28/36）］，差异有统计学意义（P<0.05）。观察组治疗3 d、7 d后疼痛数字评分量表评分及治疗后总胆红素、血清糖类抗原199水平低于对照组［（4.4±1.1）分比（5.9±1.3）分、（3.2±1.0）分比（4.3±1.1）分、（91±59）μmol/L比（121±65）μmol/L、（86±59）kU/L比（113±66）kU/L］，差异均有统计学意义(均P＜0.05)。治疗后观察组生活质量改善率高于对照组［67.5%（27/40）比47.2%（17/36）］，差异有统计学意义（P＜0.05）。2组患者治疗期间各项不良反应在1～2级，差异均无统计学意义（均P＞0.05）。观察组1年生存率高于对照组，差异有统计学意义（P＜0.05）。结论    伽马刀联合吉西他滨化疗对胰腺癌肝转移患者的近期疗效显著，能够提高患者的生存质量，延长生存时间，未增加不良反应。

• 【Abstract】Objective    To observe the short-term effect of gamma knife radiosurgery combined with gemcitabine chemotherapy on patients with liver metastasis of pancreatic cancer. Methods    A total of 76 patients with liver metastasis of pancreatic cancer admitted to the No. 901 Hospital of Joint Logistics Support Force of the Chinese People′s Liberation Army from March 2008 to March 2017 were randomly divided into control group(36 cases) and observation group(40 cases). The control group was treated with 2 cycles of gemcitabine chemotherapy. The observation group was treated with gamma knife radiosurgery and the same chemotherapy scheme as control group. Short-term efficacy, pain control effect, serum total bilirubin and carbohydrate antigen-199 levels, quality of life, adverse reactions and survival during follow-up were analyzed. Results    Clinical benefit rate in observation group was significantly higher than that in control group［95.0%（38/40） vs 77.8%（28/36）］(P<0.05). Pain Numerical Rating Scale scores at 3 d and 7 d during treatment and serum levels of total bilirubin and carbohydrate antigen-199 after treatment in observation group were significantly lower than those in control group［（4.4±1.1） vs （5.9±1.3）,（3.2±1.0） vs （4.3±1.1）, （91±59）μmol/L vs （121±65）μmol/L, （86±59）kU/L vs （113±66）kU/L］(all P<0.05). Quality of life improvement rate in observation group was significantly higher than that in control group［67.5%（27/40） vs 47.2%（17/36）］(P<0.05). Adverse reactions graded from 1 to 2 and there was no significant difference between groups(P>0.05). The 1-year survival rate in observation group was significantly higher than that in control group(P<0.05). Conclusions    Gamma knife radiosurgery combined with gemcitabine chemotherapy shows good short-term effect on patients with liver metastases of pancreatic cancer. It can improve the quality of life and prolong the survival time without increasing adverse reactions.