目的 探索吉西他滨联合伽玛刀治疗局部晚期胰腺癌的最适剂量。方法 采用“3+3”试验设计模式，患者接受伽玛刀和吉西他滨治疗，伽玛刀治疗计划52 Gy/13F，吉西他滨初始剂量700 mg/m²，每周1次，连续3周，剂量按照100 mg/m²依次递增，直至出现剂量限制性毒性反应。结果 入组9例患者，700 mg/m²和800 mg/m²组完成治疗计划，当吉西他滨的剂量递增至900 mg/m²时出现剂量限制性的血液学毒性反应，试验中止。结论 伽玛刀联合吉西他滨治疗局部晚期胰腺癌，吉西他滨的推荐剂量为800 mg/m²，每周1次，连续3周。

Objective To estimate the optimal dose of gemcitabine administered concurrently with gamma knife therapy in patients with locally advanced pancreatic cancer. Method “3+3” model was measured in the study. Eligible patients had histologically confirmed pancreatic adenocarcinoma deemed locally unresectable. Patients received gamma knife therapy (52 Gy/13F) with concurrent infused weekly gemcitabine(dose escalated from 700 mg/m² to 900 mg/m² weekly) until dose-restricted toxicity. Results 9 patients were enrolled. Patients enrolled in gemcitabine 700 mg/m² and 800 mg/m² completed the plan.III-IV degree hematology toxicity was seen in patients when gemcitabine dose escalated to 900 mg/m². Conclutions The combination of gemcitabine and gamma knife therapy is well tolerated. The optimal dose of gemcitabine is 800 mg/m² weekly.