Clinical Analysis Of Stereotactic Body Radiation Therapy Combined With S-1 In Locally Advanced Pancreatic Cancer

Objective:To evaluate the clinical efficacy and safety of stereotactic body radiation therapy combined with S-1 in the treatment of locally advanced pancreatic cancer.Methods:The clinical data of 80 patients with locally advanced unresectable pancreatic cancer in our hospital from January 2016 to February 2019 were collected.12 patients who did not meet the conditions were removed and 68 patients were enrolled.They were divided into group A and group B according to their different treatment methods.42 patients in group A received stereotactic body radiation therapy combined with S-1treatment,while 26 patients in group B received gemcitabine combined with S-1chemotherapy.Both groups of patients were reviewed regularly and completed follow-up.According to the clinical data of the two groups,the objective response rate,pain control,jaundice relief,tumor marker CA19-9 level,fasting blood glucose level and treatment toxicity of the two groups were compared and analyzed,and the progression-free survival time and overall survival time of the two groups of patients were counted.Result:1.Short-term efficacy: three months after the end of treatment,the objective response rate of group A was 80.95%(34/42),the objective response rate of group B was 57.69%(15/26),the objective response rate of group A was better than that of group B,the difference was statistically significant(P < 0.05).2.Pain: before treatment,both groups of patients had different degrees of pain.After one week of treatment,the pain relief rate of group A was 83.33%(35/42)and that of group B was 50.00%(13/26),and the difference was statistically significant(P< 0.05).One month after treatment,the pain relief rate of group A was 92.86%(39/42),and that of group B was 69.23%(18/26),and difference was statistically significant(P < 0.05).3.Jaundice symptoms: the jaundice regression rate of group A was 82.14%(23/28),and that of group B was 70.59%(12/17).After treatment,the total bilirubin level of the two groups decreased compared with that before treatment,and the difference was statistically significant(P < 0.05).There was no significant difference between the two groups(P > 0.05).4.The level of CA19-9: the difference of CA19-9 between the two groups before and after treatment was statistically significant(P < 0.05).There was no significant difference between the two groups(P > 0.05).5.Fasting blood glucose: there was no significant difference in fasting blood glucose between the two groups one month after treatment(P > 0.05).There was no significant difference between the two groups(P > 0.05).6.Toxicity: the incidence of gastrointestinal toxicity and myelosuppression in group A were lower than those in group B(45.24% vs 73.08%,33.33% vs 57.69%,respectively),and the differences were statistically significant(P < 0.05).7.Survival: 1-year survival rate,median progression free survival,median survival: group A were 54.76%,8.0 months,14.0 months,group B were 53.85%,7.3months,13.3 months,the differences were not statistically significant(P > 0.05).Conclusion:Stereotactic body radiation therapy combined with S-1 can reduce the pain and jaundice symptoms of patients with locally advanced unresectable pancreatic cancer,reduce the level of tumor marker CA19-9,and has no significant effect on fasting blood glucose.Compared with gemcitabine combined with S-1,this program has higher objective response rate,better pain control effect and lower toxicity in the treatment of locally advanced unresectable pancreatic cancer,with both effectiveness and safety.