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无法手术切除的胆管细胞癌经体部立体定向放射治疗的效果及安全性分析

赵晓芳 张爱民 李文刚 孙静 常小云 张弢 何卫平 段学章

引用本文:
Citation:

无法手术切除的胆管细胞癌经体部立体定向放射治疗的效果及安全性分析

DOI: 10.3969/j.issn.1001-5256.2023.11.021
基金项目: 

国家自然科学基金面上项目 (81972856)

伦理学声明:本研究方案于2019年3月12日经由解放军总医院第五医学中心医学伦理委员会审批,批号:2019-083D,患者均签署知情同意书。
利益冲突声明:本文不存在任何利益冲突。
作者贡献声明:赵晓芳负责起草及撰写文章;张爱民、孙静负责采集数据并统计分析;李文刚、常小云、张弢、何卫平参与分析解释数据;段学章负责总体修改文章。
详细信息
    通信作者:

    段学章, duanxuezhang2006@163.com (ORCID: 0000-0002-1941-9317)

Efficacy and safety of stereotactic body radiation therapy in treatment of patients with unresectable cholangiocarcinoma

Research funding: 

National Natural Science Foundation of China (81972856)

More Information
  • 摘要:   目的  观察体部立体定向放疗治疗无法手术切除的胆管细胞癌患者的生存情况及不良反应。  方法  选取2012年2月—2020年7月于解放军总医院第五医学中心行体部立体定向放射治疗的27例无法手术切除的单发无转移的胆管细胞癌患者。计划靶区(PTV)处方剂量42~60 Gy,分5~8次,5~11 Gy/次。其中有5例联合肝动脉化疗栓塞术(TACE)和化疗治疗。以6个月、12个月、18个月和24个月的总生存率、无进展生存率和局部控制率作为疗效评价指标。使用不良事件通用术语标准(CTCAE)v.4.03评估不良反应。采用Kaplan-Meier法计算总生存率、无进展生存率和局部控制率。  结果  中位随访时间17个月。27例患者的6个月、12个月、18个月和24个月的总生存率分别为100%、88%、57.5%和47.9%,无进展生存率分别为74.1%、58.6%、47.9%和35.9%,局部控制率分别为96.3%、91.9%、84.8%和76.4%。未出现3级及以上毒性反应。5例患者诊断为放射性肝损伤,无因放射性肝损伤死亡病例。  结论  体部立体定向放疗治疗不可切除胆管细胞癌安全、有效,具有较高的生存率、无进展生存率和局部控制率,且毒性反应低,可作为不适合手术治疗的胆管癌的替代治疗。

     

  • 图  1  27例患者总生存率

    Figure  1.  Overall survival of 27 patients

    图  2  27例患者无进展生存率

    Figure  2.  Progression-free survival of 27 patients

    图  3  27例患者局部控制率

    Figure  3.  Local control rate of 27 patients

    表  1  27例患者一般临床资料

    Table  1.   The characteristics of 27 patients

    特征 数值
    性别[例(%)]
    19(70.4)
    8(29.6)
    年龄(岁) 64(52~68)
    肿瘤位置[例(%)]
    肝内 14(51.9)
    肝门 13(48.1)
    肿瘤大小(cm) 4.5(2.6~5.1)
    肿瘤标志物
    AFP(ng/mL) 2.85(1.51~5.80)
    CA19-9(U/mL) 129.65(28.69~521.98)
    合并梗阻性黄疸[例(%)]
    15(55.6)
    12(44.4)
    ECOG PS评分[例(%)]
    0分 5(18.5)
    1分 22(81.5)
    Child-Pugh分级[例(%)]
    A级 15(55.6)
    B级 12(44.4)
    治疗方案[例(%)]
    单用SBRT 22(81.5)
    SBRT+替吉奥 4(14.8)
    SBRT+TACE+替吉奥 1(3.7)
    放疗计划
    总剂量(Gy) 50(42~60)
    单次剂量(Gy) 10(5~11)
    分割次数(次) 5(5~8)
    BED 83.0(71.4~115.0)
    注:BED,生物有效剂量。
    下载: 导出CSV
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  • 收稿日期:  2023-01-02
  • 录用日期:  2023-04-11
  • 出版日期:  2023-11-28
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