Modern radiotherapy becomes the first choice for pancreatic cancer that is difficult to cut surgically

  Non-invasive treatment of pancreatic cancer can be preferred to modern radiotherapy According to clinical data, the surgical resection rate of pancreatic cancer is about 15%, and even the efficacy of early radical surgery is still unsatisfactory, and the average survival period of pancreatic cancer in China is only 17.6 months. The reason is that the pancreatic gland is surrounded by several organs with complex anatomical structure; the infiltrative growth of pancreatic cancer often invades several organs and blood vessels, and the surgical resection of radical surgery is extensive, traumatic and the resection rate is low. Therefore, modern radiotherapy has become the first choice of many patients for the non-invasive treatment of pancreatic cancer.  Modern radiotherapy has made a breakthrough in the treatment of pancreatic cancer In recent years, modern radiotherapy has made a breakthrough in the treatment of pancreatic cancer: the use of stereotactic technology and body verification technology can improve the accuracy of positioning and determine the range of movement of the target area; modern imaging technology such as CT/MRI can more accurately determine the size of 5mm lesions in the pancreas, PET/CT can identify the benignity and malignancy of >5-10mm lesions, PET/CT can also more accurately perform clinical staging and prognosis. PET/CT can also make more accurate clinical staging and prognosis judgments; using radiotherapy planning system can achieve targeted radiotherapy, strike the target area accurately, effectively avoid normal tissue damage, and optimize the radiotherapy plan: focus high dose on the target area, minimizing the risk of radiation damage; there are a variety of modern radiotherapy equipment to provide prerequisites for focused irradiation of tumors, and implement high dose irradiation for targets below 3-5 cm, without affecting the surrounding normal tissues. The use of modern radiotherapy techniques can cure early parenchymal organ tumors, increase the dose to improve the local control rate, and change the dose splitting pattern is an effective means to improve the local control rate, and the influence of T-stage on the prognosis of radiotherapy is not as great as that of tumor volume. In addition, the body gamma knife uses the focused high dose point to fill in the target area, the dose distribution curve is highly concentrated in the target area, and the dose outside the target area decreases steeply similar to the dose distribution characteristics of particle implantation, using 50% dose line as the prescription dose does not increase the irradiation dose to normal tissues, therefore, it is conducive to the implementation of high fractionated dose and short treatment course, and also improves the radiation biological effect dose in the target area, which is It is a more reasonable and effective radiotherapy method for the treatment of malignant tumors.  Air Force General Hospital successfully radiotherapy pancreatic cancer It is reported that the use of body gamma knife treatment can not be surgically resected in 52 cases of locally progressive pancreatic cancer, the local pain relief efficiency of 82.5%, the recent local efficiency (CR + PR) 85.6%, the median survival period of 10.5 months, stage II-IV 1 and 2 years survival rate of 58.5% and 26.1% respectively. The stage II 1 and 2 year survival rates were 78.5% and 47.3%, respectively, which were higher than the majority of reported 20%-30%, indicating that gamma knife treatment for pancreatic cancer has some advantages in improving the local control rate and survival rate.  Finally, the use of body gamma knife for early limited pancreatic body and tail cancer can obtain higher local dose with less damage to the surrounding normal tissues; the use of 3D conformal radiotherapy or intensity modulated radiotherapy for larger local tumors or pancreatic head cancer has relatively uniform local dose, which can better protect normal tissues from high dose irradiation and is safer and more feasible in the case of larger irradiation area.