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[目的]对术中不可切除T4期胰腺癌进行单纯术中电子线放疗研究,探讨其安全性和疗效。[方法]2009年12月～2011年7月共入组16例术中不可切除的T4期胰腺癌。术中行电子线放疗,中位剂量18Gy,术后依病情决定是否给予化疗。分析手术时间、住院时间、不良反应、局部控制以及生存情况。[结果]手术中位时间180min,术后住院中位时间10.5d,未观察到3度以上的不良反应。1年局部控制率80.0%,1年生存率12.5%,中位生存期9.5个月。[结论]对术中不可切除的T4病变进行单次16～20Gy以上的术中放疗有效且耐受性好,能达到术后同步放化疗相似的生存率及局部控制率。但整体远处转移率高,建议对能耐受者应给予化疗。
[Objective] To study the safety and efficacy of simple intraoperative electron beam radiotherapy in unresectable T4 pancreatic cancer. [Methods] From December 2009 to July 2011, 16 patients with unresectable T4 pancreatic cancer were enrolled. Intraoperative electron beam radiotherapy, the median dose of 18Gy, according to the condition after the decision whether to give chemotherapy. Analysis of operation time, hospital stay, adverse reactions, local control and survival. [Results] The median time of operation was 180 minutes and the median hospital stay was 10.5 days. No adverse reactions of more than 3 degrees were observed. 1 year local control rate of 80.0%, 1-year survival rate of 12.5%, the median survival of 9.5 months. [Conclusion] It is effective and well tolerated to intraoperative unresectable T4 lesions with single intraoperative radiotherapy more than 16 ~ 20Gy, which can achieve similar postoperative concurrent chemoradiation and local control rate. However, the overall high rate of distant metastasis, it is recommended to be tolerant should be given chemotherapy.