Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, Kagoshima, Japan.
Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University, Kagoshima, Japan.
Pancreatology. 2017 Sep-Oct;17(5):833-838. doi: 10.1016/j.pan.2017.07.191. Epub 2017 Jul 27.
We compared the clinical outcomes of proton beam radiotherapy (PBRT) and those of conventional chemoradiotherapy via hyper-fractionated acceleration radiotherapy (HART) after induction chemotherapy in patients with locally advanced pancreatic cancer (LAPC).
Twenty-five consecutive patients with LAPC received induction chemotherapy comprising gemcitabine and S-1 before radiotherapy. Of these, 15 and 10 were enrolled in the HART and PBRT groups, respectively.
Moderate hematological toxicities were observed only in the HART group, whereas two patients in the PBRT group developed duodenal ulcers. All patients underwent scheduled radiotherapy, with overall disease control rates of 93% and 80% in the HART and PBRT groups, respectively. Local progression was observed in 60% and 40% of patients in the HART and PBRT groups, respectively. However, there was no statistical significance between the two groups regarding the median time to progression (15.4 months in both) and the median overall survival (23.4 v.s. 22.3 months).
PBRT was feasible and tolerable, and scheduled protocols could be completed with careful attention to gastrointestinal ulcers. Despite the lower incidence of local recurrence, PBRT did not yield obvious progression control and survival benefits relative to conventional chemoradiotherapy.
我们比较了诱导化疗后局部晚期胰腺癌（LAPC）患者接受质子束放疗（PBRT）和超分割加速放疗（HART）常规放化疗的临床结果。
25 例 LAPC 患者接受吉西他滨和 S-1 诱导化疗后行放疗。其中，15 例和 10 例分别入组 HART 和 PBRT 组。
仅 HART 组观察到中度血液学毒性，而 PBRT 组有 2 例患者发生十二指肠溃疡。所有患者均按计划行放疗，HART 和 PBRT 组的总疾病控制率分别为 93%和 80%。HART 和 PBRT 组的局部进展率分别为 60%和 40%。然而，两组之间的中位无进展时间（15.4 个月）和中位总生存期（23.4 个月比 22.3 个月）均无统计学意义。
PBRT 是可行且可耐受的，只要仔细注意胃肠道溃疡，就可以完成预定的方案。尽管局部复发率较低，但与常规放化疗相比，PBRT 并未带来明显的进展控制和生存获益。
