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放射治疗在胰胆神经内分泌肿瘤中的作用。

Role of radiotherapy for pancreatobiliary neuroendocrine tumors.

作者信息

Lee Jeongshim, Choi Jinhyun, Choi Chihwan, Seong Jinsil

机构信息

Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Radiat Oncol J. 2013 Sep;31(3):125-30. doi: 10.3857/roj.2013.31.3.125. Epub 2013 Sep 30.

Abstract

PURPOSE

We investigated the role of radiotherapy (RT) for pancreatobiliary neuroendocrine tumors (PB-NETs).

MATERIALS AND METHODS

We identified 9 patients with PB-NETs who received RT between January 2005 and March 2012. Of these 9 patients, 4 were diagnosed with NETs in the pancreas and 5 were diagnosed with NETs in the gallbladder. All patients received RT to the primary tumor or resection bed with a median total irradiation dose of 50.4 Gy, with or without chemotherapy.

RESULTS

The tumor response rate and tumor control rate in the RT field were 60% and 100 %, respectively. All 4 patients who underwent surgery had no evidence of disease in the RT field. Of the 5 patients who received RT to the primary gross tumor, 1 had complete response, 2 had partial response, and 2 had stable disease in the RT field. The median time to progression was 11 months. Of the 9 patients, four patients had no progression, and 5 patients had progression of disease (locoregional, 2; distant, 2; locoregional/distant, 1). Of the 4 patients without progression, 3 were treated with RT in adjuvant or neoadjuvant setting, and one received RT to primary tumor. One patient experienced radiation-induced duodenitis at 3 months after concurrent chemoradiation without treatment-related mortality.

CONCLUSION

RT can yield local control for advanced PB-NETs. RT should be considered an essential part of multimodality treatment in management of advanced PB-NETs.

摘要

目的

我们研究了放射治疗(RT)在胰胆神经内分泌肿瘤(PB-NETs)中的作用。

材料与方法

我们确定了9例在2005年1月至2012年3月期间接受RT的PB-NETs患者。在这9例患者中,4例被诊断为胰腺神经内分泌肿瘤,5例被诊断为胆囊神经内分泌肿瘤。所有患者均接受了针对原发肿瘤或切除床的RT,中位总照射剂量为50.4 Gy,同时接受或不接受化疗。

结果

RT区域的肿瘤反应率和肿瘤控制率分别为60%和100%。所有4例接受手术的患者在RT区域均无疾病证据。在5例接受原发大肿瘤RT的患者中,1例完全缓解,2例部分缓解,2例在RT区域疾病稳定。中位进展时间为11个月。9例患者中,4例无进展,5例疾病进展(局部区域进展2例;远处转移2例;局部区域/远处转移1例)。在4例无进展的患者中,3例在辅助或新辅助治疗中接受了RT,1例接受了原发肿瘤的RT。1例患者在同步放化疗后3个月出现放射性十二指肠炎症,无治疗相关死亡。

结论

RT可实现晚期PB-NETs的局部控制。RT应被视为晚期PB-NETs多模式治疗的重要组成部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/315a/3797271/46d2b0f4a15d/roj-31-125-g001.jpg

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