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ENGLISH ABSTRACT
体部立体定向放疗联合化疗治疗局部晚期胰腺癌的临床疗效评价
王谦
王亚婷
吴云龙
作者及单位信息
·
DOI： 10.3760/cma.j.cn341190-20240505-00505
Evaluation of clinical efficacy of stereotactic body radiotherapy combined with chemotherapy for locally advanced pancreatic cancer
Wang Qian
Wang Yating
Wu Yunlong
Authors Info & Affiliations
Wang Qian
Department of General Surgery, Weinan Central Hospital, Weinan 714000, Shaanxi Province, China
Wang Yating
Department of Gastroenterology, Weinan Central Hospital, Weinan 714000, Shaanxi Province, China
Wu Yunlong
Department of General Surgery, Weinan Central Hospital, Weinan 714000, Shaanxi Province, China
·
DOI： 10.3760/cma.j.cn341190-20240505-00505
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摘要

目的探讨在治疗局部晚期胰腺癌患者时，体部立体定向放疗与化疗联合应用的临床效果。

方法本研究为前瞻性随机对照研究，共纳入陕西省渭南市中心医院2020年1月至2022年6月收治的局部晚期胰腺癌患者80例。患者采取摸球法随机分为两组，对照组（ n=40）接受化疗及常规药物治疗，观察组（ n=40）在对照组基础上联合体部立体定向放疗，并对每例患者随访1年。比较两组患者的胰腺癌局部控制率（LCR）、血清癌抗原19-9水平（CA19-9）、癌胚抗原（CEA）、腹痛缓解率、黄疸消退率、不良反应发生率和一年生存率。

结果观察组患者局部控制率达到85.00%（34/40），高于对照组，差异有统计学意义（ χ 2=5.23， P < 0.05）。治疗后观察组CA19-9、CEA水平低于对照组，差异均有统计学意义（ χ 2=2.60、3.97，均 P < 0.001）；观察组的一年存活率达到65.00%（26/40），高于对照组的42.50%（17/40），差异有统计学意义（ χ 2=4.07， P < 0.05）。而在不良反应发生率方面，两组之间差异均无统计学意义（ χ 2=2.58、0.05、0.39、2.05，均 P > 0.05）。

结论体部立体定向放疗联合化疗在局部晚期胰腺癌患者中表现出较好的治疗效果，同时并未显著增加不良反应的风险。因此，这种联合治疗方案可作为局部晚期胰腺癌治疗的有效选择。

胰腺肿瘤;放射疗法;药物疗法;CA-19-9抗原;癌胚抗原;药物相关性副作用和不良反应
ABSTRACT

ObjectiveTo investigate the clinical efficacy of stereotactic body radiotherapy combined with chemotherapy in the treatment of patients with locally advanced pancreatic cancer.

MethodsThis study is a prospective randomized controlled study that included 80 patients with locally advanced pancreatic cancer admitted to Weinan Central Hospital from January 2020 to June 2022. Patients were randomly divided into two groups using a drawing lots method: the control group ( n = 40) received chemotherapy and conventional medication, while the observation group ( n = 40) received stereotactic body radiotherapy in addition to the treatments in the control group. Each patient was followed up for 1 year. The local control rate of pancreatic cancer, levels of serum carbohydrate antigen 19-9 and carcinoembryonic antigen, abdominal pain relief rate, jaundice resolution rate, incidence of adverse reactions, and 1-year survival rate were compared between the two groups.

ResultsThe local control rate in the observation group reached 85.00% (34/40), which was significantly higher than that in the control group ( χ 2 = 5.23, P < 0.05). After treatment, the levels of serum carbohydrate antigen 19-9 and carcinoembryonic antigen in the observation group were significantly lower than those in the control group ( χ 2 = 2.60, 3.97, both P < 0.001). The 1-year survival rate in the observation group was 65.00% (26/40), which was significantly higher than that in the control group [42.50% (17/40), χ 2 = 4.07, P < 0.05). However, there was no significant difference in incidence of adverse reactions between the two groups ( χ 2 = 2.58, 0.05, 0.39, 2.05, all P > 0.05).

ConclusionsStereotactic body radiotherapy combined with chemotherapy has shown good therapeutic effects in patients with locally advanced pancreatic cancer, without significantly increasing the risk of adverse reactions. Therefore, this combination treatment regimen can be considered an effective option for the treatment of locally advanced pancreatic cancer.

Pancreatic neoplasms;Radiotherapy;Drug therapy;CA-19-9 antigen;Carcinoembryonic antigen;Drug-related side effects and adverse reactions
Wang Yating, Email: mocdef.qabq251439393
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引用本文

王谦,王亚婷,吴云龙. 体部立体定向放疗联合化疗治疗局部晚期胰腺癌的临床疗效评价[J]. 中国基层医药,2025,32(03)：359-363.

DOI:10.3760/cma.j.cn341190-20240505-00505

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胰腺癌作为一种高度恶性的肿瘤，其诊断和治疗一直是医学研究的难点与重点 ［ 1 ］ 。特别是在局部晚期胰腺癌的治疗领域，由于其特殊的解剖位置和晚期发现的特点，传统的治疗方法往往效果有限，对患者的生存期和生活质量影响甚大 ［ 2 ］ 。在这种背景下，新的治疗策略的探索显得尤为重要。传统的胰腺癌治疗方法主要依赖于手术、化疗和放疗，但局部晚期胰腺癌患者由于肿瘤的位置、大小或与周围组织的粘连，常常不适合手术治疗 ［ 3 ］ 。而单纯的化疗或放疗往往效果不理想，且副作用较大。体部立体定向放疗作为一种精准的放疗技术，其定位精确，可以最大限度地减少对周围正常组织的损伤，从而提高放疗的精准度和安全性 ［ 4 ］ 。当其与化疗相结合，理论上可以增强治疗效果，同时控制不良反应的风险 ［ 5 ］ 。本研究旨在系统评估体部立体定向放疗联合化疗在局部晚期胰腺癌治疗中的临床疗效和安全性。
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备注信息
A
王亚婷，Email： mocdef.qabq251439393
B

王谦：文章主题构思及基本设计、起草文章、完成外科数据采集及汇总、同时取得医院伦理审批、论文授权书及利益冲突公开声明等行政工作；王亚婷：参与文章设计、完成内科部分数据采集及汇总、采用SPSS数据分析统计系统完成对数据的分析；吴云龙：对采集数据进行校对、查阅相关文献对文章进行指导及支持、对终稿进行审阅

C
王谦, 王亚婷, 吴云龙. 体部立体定向放疗联合化疗治疗局部晚期胰腺癌的临床疗效评价[J]. 中国基层医药,2025,32(3):359-363. DOI:10.3760/cma.j.cn341190-20240505-00505.
D
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