Rich T A, Evans D B
Department of Radiotherapy, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
World J Surg. 1995 Mar-Apr;19(2):264-9. doi: 10.1007/BF00308636.
Combined modality therapy can be administered prior to surgical resection for patients with operable pancreatic cancer. One important criteria used to select patients for this treatment sequence is the absence of arterial vascular encasement by tumor on thin-section CT scanning; the absence of peritoneal seeding on surgical staging or laparoscopy has been another important parameter used in identifying patients with "localized" disease. Preoperative treatment with infusional chemoradiation uses multiple fields of irradiation delivering a dose of 50.4 Gy in 28 fractions over 5 1/2 weeks. This is done in conjunction with a continuous infusion of 5-fluorouracil intravenously at a dosage of 300 mg/m2/day with each day of radiotherapy treatment. The initial results of this protocol indicate acceptable toxicity and no evidence of increased perioperative morbidity or mortality compared to series using operation alone. We conclude that nearly all patients eligible for this combined modality treatment approach complete therapy as prescribed with acceptable toxicity.
对于可手术切除的胰腺癌患者，可在手术切除前进行综合治疗。用于选择接受该治疗方案患者的一个重要标准是薄层CT扫描显示肿瘤未包绕动脉血管；手术分期或腹腔镜检查未发现腹膜种植转移是另一个用于识别“局限性”疾病患者的重要参数。术前同步放化疗采用多个照射野，在5.5周内分28次给予50.4 Gy的剂量。这与在放疗的每一天静脉持续输注剂量为300 mg/m²/天的5-氟尿嘧啶同时进行。该方案的初步结果表明，与单纯手术系列相比，毒性可接受，且没有围手术期发病率或死亡率增加的证据。我们得出结论，几乎所有符合这种综合治疗方法的患者都能按规定完成治疗，且毒性可接受。
