以低剂量吉西他滨联合大面积照射作为新辅助放化疗对局部进展期胰腺癌进行R0切除
R0 Resection for Locally Advanced Pancreatic Cancer with Low-dose Gemcitabine with Wide Irradiation Area as Neoadjuvant Chemoradiotherapy.
作者信息
Kamachi Hirofumi, Tsuruga Yousuke, Orimo Tatsuya, Wakayama Kenji, Shimada Shingo, Nagatsu Akihisa, Yokoo Hideki, Kamiyama Toshiya, Katoh Norio, Taketomi Akinobu
机构信息
Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
出版信息
In Vivo. 2018 Sep-Oct;32(5):1183-1191. doi: 10.21873/invivo.11362.
BACKGROUND
Local antitumor efficacy and the outcome of neoadjuvant chemoradiotherapy (NACRT) with low-dose gemcitabine and wide irradiation area for borderline resectable and unresectable pancreatic cancer were evaluated.
PATIENTS AND METHODS
Thirty-four cases of borderline resectable and unresectable pancreatic cancer were recruited. Three-dimensional conformal radiotherapy to the pancreatic bed and the region scheduled for lymph node dissection was performed to a total dose of 50.4 Gy28 fractions with gemcitabine at a dose of 150 mg/m weekly. Clinical and pathological results were examined.
RESULTS
Twenty-seven patients (79.4%) completed the protocol. Grade 3/4 leucopenia (n=10), and grade 3 anorexia (n=1) occurred. Seven cases were excluded (two refused treatment; five had progressive disease), 20 underwent laparotomy, and 16 resected (47.1%) cases achieved R0 resection. Median survival time, and 3-year and 5-year survival rates were 39.0 months, and 56.3% and 28.1% in resected cases, respectively.
CONCLUSION
NACRT with low-dose gemcitabine and wide irradiation area achieved 100% R0 resection and acceptable prognosis.
背景
评估低剂量吉西他滨联合大面积照射区域的新辅助放化疗（NACRT）对临界可切除和不可切除胰腺癌的局部抗肿瘤疗效及结果。
患者与方法
招募34例临界可切除和不可切除胰腺癌患者。对胰腺床及计划进行淋巴结清扫的区域进行三维适形放疗，总剂量为50.4 Gy，分28次进行，同时每周给予吉西他滨150 mg/m²。检查临床和病理结果。
结果
27例患者（79.4%）完成方案。发生3/4级白细胞减少（n = 10）和3级厌食（n = 1）。7例被排除（2例拒绝治疗；5例疾病进展），20例行剖腹手术，16例（47.1%）切除病例实现R0切除。切除病例的中位生存时间、3年和5年生存率分别为39.0个月、56.3%和28.1%。
结论
低剂量吉西他滨联合大面积照射区域的新辅助放化疗实现了100%的R0切除和可接受的预后。
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