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首页> 外文期刊>Acta oncologica. >Proton therapy with concomitant capecitabine for pancreatic and ampullary cancers is associated with a low incidence of gastrointestinal toxicity
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Proton therapy with concomitant capecitabine for pancreatic and ampullary cancers is associated with a low incidence of gastrointestinal toxicity

机译：质子疗法联合卡培他滨治疗胰腺癌和壶腹癌与胃肠道毒性的发生率低相关

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Background. To review treatment toxicity for patients with pancreatic and ampullary cancer treated with proton therapy at our institution. Material and methods. From March 2009 through April 2012, 22 patients were treated with proton therapy and concomitant capecitabine (1000 mg PO twice daily) for resected (n = 5); marginally resectable (n = 5); and unresectable/inoperable (n = 12) biopsy-proven pancreatic and ampullary adenocarcinoma. Two patients with unresectable disease were excluded from the analysis for reasons unrelated to treatment. Proton doses ranged from 50.40 cobalt gray equivalent (CGE) to 59.40 CGE. Results. Median follow-up for all patients was 11 (range 5-36) months. No patient demonstrated any grade 3 toxicity during treatment or during the follow-up period. Grade 2 gastrointestinal toxicities occurred in three patients, consisting of vomiting (n = 3); and diarrhea (n = 2). Median weight loss during treatment was 1.3 kg (1.75% of body weight). Chemotherapy was well-tolerated with a median 99% of the prescribed doses delivered. Percentage weight loss was reduced (p = 0.0390) and grade 2 gastrointestinal toxicity was eliminated (p = 0.0009) in patients treated with plans that avoided anterior and left lateral fields which were associated with reduced small bowel and gastric exposure. Discussion. Proton therapy may allow for significant sparing of the small bowel and stomach and is associated with a low rate of gastrointestinal toxicity. Although long-term follow-up will be needed to assess efficacy, we believe that the favorable toxicity profile associated with proton therapy may allow for radiotherapy dose escalation, chemotherapy intensification, and possibly increased acceptance of preoperative radiotherapy for patients with resectable or marginally resectable disease.
机译：背景。回顾我们机构对质子疗法治疗的胰腺和壶腹癌患者的治疗毒性。材料与方法。从2009年3月至2012年4月，有22例患者接受了质子治疗并伴有卡培他滨（每天两次1000 mg PO）治疗（n = 5）。可切除的（n = 5）;和无法切除/无法手术（n = 12）的活检证实的胰腺和壶腹腺癌。由于与治疗无关的原因，将两名无法切除的疾病患者排除在分析之外。质子剂量范围从50.40钴灰色当量（CGE）到59.40 CGE。结果。所有患者的中位随访时间为11（5-36）个月。在治疗期间或随访期间，没有患者表现出任何3级毒性。 3名患者发生了2级胃肠道毒性反应，包括呕吐（n = 3）;和腹泻（n = 2）。治疗期间体重减轻的中位数为1.3千克（体重的1.75％）。化疗耐受性良好，中位处方剂量的中位数为99％。采用避免与小肠和胃部暴露减少相关的前，左外侧视野的计划治疗的患者，体重减轻的百分比降低了（p = 0.0390），并且消除了2级胃肠道毒性（p = 0.0009）。讨论。质子治疗可能使小肠和胃明显保留，并伴有较低的胃肠道毒性。尽管需要长期随访以评估疗效，但我们认为与质子治疗相关的有利毒性谱可能使放疗剂量升高，化疗强度增强，并可能增加可切除或可切除部分疾病患者术前放疗的接受度。

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