Prospective Clinical Study of γ-Ray Stereotactic Body Radiation Therapy for Locally Advanced Pancereatic Carcinoma
|School||Hebei North University|
|Course||Pathology and Pathophysiology|
|Keywords||local advanced pancreatic cancer γ-ray stereotactic bodyradiation therapy clinical research prognosis multiplicity|
The paper is to evaluate the efficacy and toxicity of y-ray stereotactic body radiation therapy for locally advanced pancreatic carcinoma and analyse the influence factors of prognosis in advanced pancreatic carcinoma. In order to improve survival and quality of life increasingly.In our department,65patients who were enrolled with local pancreatic carcinoma were treated with the y-ray stereotactic body radiation therapy prospectively. Low-speed computed tomography simulation was conducted. The patients who were supine were fixed by a stereotactic body frame and vacuum bag. GTV, CTV and PTV were defined on the contrast CT scans. It adapted a new model of hyperfractionated dose, short course, different doses of line surrounding layers for different target dose increments. The daily radiation doses of50%isodose line covering pancreas tumors are from3Gy to5Gy and5fractions per week according to the tumor size.45Gy-51Gy total doses in the edge of50%isodose line were divided into (3Gy-5Gy/fractions)15fractions-17fractions. All patients Clinical data were analyzed by Kaplan-Meier and log-rank method, the prognostic factors were analyzed by Cox proportional hazard model. Univariate and multivariate analyses were performed to examine factors affecting clinical outcome.15(23.8%) lesions completely disappeared,31(47.69%) lesions were assessed into partial responses. The total reponse rate (CR+PR) was70.77%. The overall survival rate of1year was52.4%and the median survival time was13months; the local progression-free survival rate and far turn survival rate of1year was86.1%and37.4%, respectively.33(50.77%) and12(18.46%) patients occurred gastrointestinal reaction and were diagnosed with RTOG grade1and RTOG grade Ⅱ, respectively.18(27.69%) patients developed acute leukocytopenia grade Ⅰ, and5persons (7.7%) were identified leukocytopenia grade Ⅱ. All patients tolerated the treatment well and completed the planned therapy. Univariate analysis showed that TNM stage and CA199>425.8425.8U-mL-1were all significant predictors for poor survival. In the results of cox multiplicity analysis, TNM stage and CA199≥425.8U·mL-1retain their independent significance in prognosis of pancreatic cancer.y-ray stereotactic body radiation therapy can result in a good curative effect and local control in treatment with locally advanced pancreatic cancer. At the same time, no severely adverse effect was occurred. This treatment alleviates patients’ suffering effectively, and improves living qualities increasingly. TNM stage and CA199≥425.8U·mL-1were provided as reference for prognosis of locally advanced pancreatic carcinoma. And it provides more scientific reference for the diagnosis and treatment of locally advanced pancreatic carcinoma.