Atasoy Beste Melek, Dane Faysal, Uçüncü Kefelı Ayşegül, Cağlar Hale, Cıngı Asım, Turhal Nazım Serdar, Abacioğlu Ufuk, Yeğen Cumhur
Departments of, Radiation Oncology, Marmara University School of Medicine, İstanbul.
Turk J Gastroenterol. 2011 Feb;22(1):60-4. doi: 10.4318/tjg.2011.0158.
BACKGROUND/AIMS: This study aimed to demonstrate the efficacy and tolerability of low-dose weekly gemcitabine as a radiosensitizer in unresectable pancreatic cancer patients treated with chemoradiotherapy.
Twenty-four histologically confirmed pancreatic carcinoma patients (female/male: 10/14, median age: 60) were evaluated. Seven (29%) patients received gemcitabine either as a single agent or in combination prior to chemoradiotherapy. Concurrent 75 mg/m2 gemcitabine was infused weekly. Radiotherapy was delivered to the primary tumor and positive lymphatics with 3D-conformal radiotherapy to a total dose of 4500 cGy. Local progression-free survival, distant metastasis-free survival and overall survival were evaluated by Kaplan-Meier method.
Median follow-up was 36 weeks. Median local progression-free survival, distant metastasis-free survival and overall survival were 22 weeks (95% confidence interval [CI]: 5-59 weeks), 19 weeks (95%CI: 6.9-31 weeks) and 36 weeks (95%CI: 28-43 weeks), respectively. All patients completed radiotherapy as scheduled. Concurrent gemcitabine was given fully in 58.3% of patients. Gemcitabine was terminated in four (16.6%) patients due to grade 3 neutropenia (n=1), grade 3 nausea/vomiting (n=2) or patient's reluctance (n=1). Patients with local response and stable disease to chemoradiotherapy revealed a median survival of 39 weeks (95%CI: 30-47.9 weeks) compared to 36 weeks (95%CI: 9.7-62.2 weeks) in patients with locally progressive disease (p=0.52). Pain was improved in 50% of patients.
Weekly low-dose radiosensitizing gemcitabine is effective and safe in unresectable pancreatic cancer patients.
背景/目的：本研究旨在证明低剂量每周一次吉西他滨作为放射增敏剂在接受放化疗的不可切除胰腺癌患者中的疗效和耐受性。
对24例经组织学确诊的胰腺癌患者（女性/男性：10/14，中位年龄：60岁）进行评估。7例（29%）患者在放化疗前接受了吉西他滨单药或联合治疗。每周静脉输注75mg/m²吉西他滨。采用三维适形放疗对原发肿瘤和阳性淋巴结进行放疗，总剂量为4500cGy。采用Kaplan-Meier法评估局部无进展生存期、远处无转移生存期和总生存期。
中位随访时间为36周。中位局部无进展生存期、远处无转移生存期和总生存期分别为22周（95%置信区间[CI]：5-59周）、19周（95%CI：6.9-31周）和36周（95%CI：28-43周）。所有患者均按计划完成放疗。58.3%的患者全程接受了同步吉西他滨治疗。4例（16.6%）患者因3级中性粒细胞减少（n=1）、3级恶心/呕吐（n=2）或患者意愿（n=1）而终止吉西他滨治疗。对放化疗有局部缓解和病情稳定的患者，中位生存期为39周（95%CI：30-47.9周），而局部病情进展的患者中位生存期为36周（95%CI：9.7-62.2周）（p=0.52）。50%的患者疼痛得到改善。
每周低剂量吉西他滨作为放射增敏剂在不可切除胰腺癌患者中有效且安全。
