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目的:观察低氧放疗对局部晚期胰腺癌的临床疗效及毒副作用。方法:将52例局部晚期胰腺癌患者随机分入低氧放疗组(试验组)和常规放疗组(对照组),试验组患者在放疗时吸入低浓度氧,对照组则吸入空气。两组患者均采用三维适形放疗(3D-CRT),总量50～56Gy。观察两组患者的近期疗效、临床获益率、远处转移率、生存率及放疗反应。结果:试验组和对照组的有效率分别为52%和48%,χ2=0.080 0,P=0.777 3;临床获益率分别为84%和64%,χ2=2.598 8,P=0.106 9;远处转移率分别为52%和80%,χ2=4.362 2,P=0.036 6;1年生存率分别为56%和44%,χ2=0.720 0,P=0.396 1;2年生存率分别为36%和12%,χ2=3.947 4,P=0.046 9;两组放疗反应主要表现为白细胞减少、恶心呕吐及腹泻,试验组发生率均低于对照组,χ2=5.194 8,P=0.022 7;χ2=4.367 2,P=0.036 6;χ2=3.947 4,P=0.046 9。结论:低氧放疗对局部晚期胰腺癌具有明显放射防护作用,并可能提高患者远期生存率。
Objective: To observe the clinical effect and toxicity of hypoxic radiotherapy on locally advanced pancreatic cancer. Methods: Fifty-two patients with locally advanced pancreatic cancer were randomly divided into hypoxia radiotherapy group (experimental group) and conventional radiotherapy group (control group). Patients in the test group inhaled low concentration of oxygen during radiotherapy and inhaled air in the control group. Two groups of patients using three-dimensional conformal radiotherapy (3D-CRT), the total 50 ~ 56Gy. The curative effect, clinical benefit rate, distant metastasis rate, survival rate and radiotherapy response of the two groups were observed. Results: The effective rates of the experimental group and the control group were 52% and 48%, respectively, χ2 = 0.080 0, P = 0.777 3; the clinical benefit rates were 84% and 64%, respectively, χ2 = 2.598 8 and P = 0.106 9; The distant metastasis rates were 52% and 80% respectively (χ2 = 4.362 2, P = 0.036 6). The 1-year survival rates were 56% and 44% respectively, χ2 = 0.720 0 and P = 0.396 1. The 2-year survival rates were 36% and 12% respectively, χ2 = 3.947 4, P = 0.046 9. The two groups showed the leukopenia, nausea, vomiting and diarrhea. The incidence of the experimental group was lower than that of the control group (χ2 = 5.194 8, P = 0.022 7 ; χ2 = 4.367 2, P = 0.036 6; χ2 = 3.947 4, P = 0.046 9. Conclusion: Hypoxic radiotherapy has obvious radioprotective effect on locally advanced pancreatic cancer and may improve the long-term survival rate of patients.