• Original article (Clinical research) • Previous Articles     Next Articles

Analysis of therapeutic effect of radiotherapy for 117 pancreatic cancer patients without distant metastasis

HU Bin1, XU Lei1, BAI Yong-rui1, YE Ming1, SUN Xiao-guang2, SONG Shao-li2   

  1. 1.Department of Radiation Oncology, 2.Department of Nuclear Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2015-08-28 Published:2015-09-30
  • Supported by:

    National Natural Science Foundation of China, 81471708, 81101073

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Abstract:

Objective  To explore and compare the safety and outcome between separate usage of three-dimensional conformal radiotherapy or γ ray stereotactic body radiotherapy or combined usage of three-dimensional conformal radiotherapy and γ ray stereotactic body radiotherapy for pancreatic cancer patients without distant metastasis. Methods  A total of 117 pancreatic cancer patients without distant metastasis were enrolled. Among them, 34 patients underwent three-dimensional conformal radiotherapy, 22 patients underwent γ ray stereotactic body radiotherapy, and 61 patients underwent γ ray stereotactic body radiotherapy after three-dimensional conformal radiotherapy. The responses of patients towards radiotherapy and the outcome of radiotherapy were observed. Results  The clinical symptoms of patients were alleviated after radiotherapy and the pain relief rate was 82.1% (64/78). The median survival time (MST) of all patients was 10.1 months and the one-year survival rate was 39.9%. MSTs of patients who underwent three-dimensional conformal radiotherapy, γ ray stereotactic body radiotherapy, and γ ray stereotactic body radiotherapy after three-dimensional conformal radiotherapy were 7.5, 10.3, and 12.4 months, respectively. The outcome of patients who underwent γ ray stereotactic body radiotherapy after three-dimensional conformal radiotherapy was better than that of patients who underwent three-dimensional conformal radiotherapy, and the MSTs were 12.4 and 7.5 months and one-year survival rates were 49.9% and 22.7%, respectively (χ2=3.300, P=0.069). The prognosis of patients with high KPS scores before radiotherapy (≥90), tumors located in pancreatic tail, tumor staging were T1-T3, CA19-9 level was less than 150 U/mL before radiotherapy, and gross tumor volume (GTV) was smaller than 100 cm3 was better. These factors were all independent prognostic factors. Conclusion  Radiotherapy can significantly improve the life quality of pancreatic cancer patients without distant metastasis who are unable to undergo operations and extend their survival time. For these patients, the outcome of γ ray stereotactic body radiotherapy after three-dimensional conformal radiotherapy is better than traditional treatment.