目的 回顾性评价三维适形放疗联合卡培他滨同步化疗治疗非手术肝门部胆管癌的疗效和不良反应。方法 对19例不符合手术指征的肝门胆管癌患者行三维适形放疗联合卡培他滨同步化疗,放疗2Gy/次,5次/周,计划照射50 Gy/25次。放疗第1天开始口服卡培他滨,早1 g,晚2 g。结果 12例(63.2%)达部分缓解(partial remission,PR),7例(36.8%)达稳定(stable disease, SD)。中位生存期12.7个月(4.3~ 20.8个月),中位无病生存期9.3个月(3.6~18.6个月)。3例(15.8%)发生3级毒性反应,无4级毒性反应。结论 三维适形放疗联合卡培他滨同步化疗对肝门胆管癌非手术治疗有效,且安全。

Objective To retrospectively analyze the efficacy and toxicity of unresectable hilar cholangiocarcinoma treated with concurrent capecitabine and radiation therapy. Methods Nineteen patients with unresectable hilar cholangiocarcinoma underwent concurrent chemo-radiotherapy protocol from May 2005 through March 2012. All patients received three-dimensional conformal radiotherapy (3D-CRT), 5 times a week at 2 Gy per fraction per day to a total dose of 50 Gy. Concurrent chronomodulated capecitabine was administered on days of irradiation in a dosage of 1 g in the morning and 2 g in the evening. Results All patients completed the treatment course. Twelve patients(63.2%)achieved a PR, and seven (36.8%) achieved a SD at the first follow-up examination. The median survival time was 12.7 months (range 4.3 to 20.8 months) and the median disease-free survival time was 9.3 months (range 3.6 to 18.6 months). A cumulative grade 3 toxicity was observed in 3 out of the 19 patients (15.8%). No patient had any grade 4 toxicity. Conclusions Concurrent capecitabine and radiation therapy is effective and tolerable in patients with unresectable hilar cholangiocarcinoma.