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目的 探讨胰腺癌综合治疗中不同剂量放射治疗对于化学治疗疗效可能产生的影响。方法 采用高效液相色谱法 (HPLC)分别测定了大白鼠经60 Co胰腺外照射 0、2、10、2 0、30、40Gy后 8h ,静注 5 氟尿嘧啶 (5 FU) (93.75mg·kg-1)在胰腺组织中的穿透比 (PR)。同行胰腺病理检查。结果 5 FU在大鼠胰腺组织中的穿透比在小剂量 (2Gy)放疗后 8h较对照组明显升高。在大剂量放疗 (≥ 10Gy)后 8h ,PR随放疗剂量的增加而增加 (相关系数r=0 .99) ,但PR均低于或与正常对照组差异无显著意义 (P <0 .0 5 )。且在 2 0Gy剂量组中胰岛细胞已出现部分退化、变性。结论 分次治疗常用剂量(2Gy)放疗后 ,同时加用化疗 ,5 FU在胰腺组织中穿透比明显升高 ,可能会取得较好的化疗效果 ,二者具协同作用。中、大剂量放疗时 (≥ 10Gy) ,急性期合并化疗 ,放射治疗在一定程度上可能会降低血胰屏障对 5 FU的通透性 ,影响化学治疗的效果。大剂量放疗时 (2 0Gy) ,急性期即可出现胰岛细胞损伤。
Objective To investigate the effects of different doses of radiotherapy on the curative effect of chemotherapy in the comprehensive treatment of pancreatic cancer. Methods High-performance liquid chromatography (HPLC) was used to determine the effects of 5-fluorouracil (5 FU) (93.75 mg · kg- 1) penetration ratio in pancreatic tissue (PR). Peer pancreatic pathology. Results The penetration of 5 FU in rat pancreatic tissue was significantly higher than that of the control group at 8 hours after radiotherapy at low dose (2Gy). PR increased with the increase of radiotherapy dose (r = 0.99) at 8h after high-dose radiotherapy (≥ 10Gy), but no significant difference was found between PR and normal control group (P <0.05) ). And in 20 Gy dose group islet cells have been partially degenerated. CONCLUSIONS: After treated with 2 Gy of the common dose (5 Gy), chemotherapy combined with 5 FU can significantly increase the penetration rate of pancreatic tissue, which may result in better chemotherapeutic effect. Medium and large doses of radiotherapy (≥ 10Gy), acute chemotherapy and radiotherapy to a certain extent, may reduce the blood-pancreatic barrier to 5 FU permeability, the impact of chemotherapy. High-dose radiotherapy (20Gy), acute pancreatic islet cell damage can occur.