Bünyamin KAPLAN, Okan ORHAN, Serdar SOYUER, Eray KARAHACIOĞLU, Oğuz G. YILDIZ

Pankreas kanseri tedavisinde radyoterapinin etkinliğinin doz ile ilişkisi

Çalışmanın amacı, pankreas kanserlerinin tedavisinde, uygulanan radyoterapi dozunun, genel sağkalım oranları üzerine etkisinin incelenmesidir. Retrospektif olarak yapılan bu çalışmaya Erciyes Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalı'nda radyoterapi uygulanan 22'si opere, 6'sı inoperabl 28 pankreas kanseri olgusu dahil edilmiştir. Öpere edilen olgulardan sadece üçünde radikal rezeksiyon yapılmış, 19'ünda pal-yatif cerrahi girişim uygulanmıştır. Tüm olgular Co-60 teleterapi cihazıyla, günlük 180-200 cGy'lik dozlarla ve haftada beş gün ışınlanmışlardır. Olgularda, toplam tedavi dozları 2700 ile 5400cGy arasında değişmektedir. Toplam 3600 cGy'in altında radyoterapi uygulanan 12 olgu ve 3600 cGy'in üzerinde uygulanan 16 olgu genel sağkalım oranları açısından karşılaştırılmıştır. Ortalama takip süresi 9,7 ay, tüm olguların ortalama yaşam süreleri 9,7 ( 2,1 -17,3 ) ay olarak hesaplanmıştır. Üçbin altıyüz cGy'in altında RT uy-gulanan olguların genel sağkalimlan 7,4 (2,1- 9,4) ay olarak hesaplanırken 3600 cGy ve/veya üzerinde RT uygulanan olgularda ortalama genel sağkalım 11,4 (3,2-17,3) ay olarak hesaplanmıştır. Log-Rank analiziyle yapılan karşılaştırmada aralarındaki fark istatistiksel olarak oldukça anlamlı bulunmuştur (p=0,0003). Sonuç olarak, pankreas kanserlerinin tedavisinde, radyoterapinin 3600 cGy'in üzerinde uygulanması halinde sağkalım avantajı sağladığı gözlenmiştir.

The effect of total radiation dose on survival in pancreatic cancer

The aim of this study was to investigate the effect of total radiation doses on survival in pancreatic cancer patients. This retrospective study was performed at the Erciyes University Department of Radiation Oncology on 28 patients with pancreatic cancer. Of these, 22 were considered operable and six inoperable. Three out of 28 patients were treated by radical resection before radiotherapy, and pal-liative surgery was performed on 19 patients. All patients were treated with doses of 180-200 cGy/day for five days per week using a Co-60 teletherapy device. Total treatment doses ranged between 2700-5400 cGy, A comparison was made between survival rates for patients receiving more than 3600cGy and those receiving less than 3600cGy. The median follow-up time was 9.7 months. The overall survival rate for both groups was 9.7 months. The survival rates for patients receiving more than 36 Gy and patients receiving less than 36 Gy were 11.4 months and 7.4 months, respectively, showing a statistically significant difference between the two groups (p=0,0003). Radiotherapy has been shown to have more effect on overall survival rates when doses higher than 3600cGy are given.

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