Abstract: Objective To observe the effects and toxicities of the patients with advanced pancreatic cancer treated with 3D-CRT combined with chemotherapy or chemotherapy alone.Methods 40 patients with advanced pancreatic cancer from January, 2000 to June, 2006 were divided into three groups:chemotherapy alone group(20 patients)3D-CRT with FH group(8 patients)3D-CRT with GP group(12 patients).Three dimensional conformal radiotherapy(3D-CRT)carried out as following:CT simulation localization, 3D-TPS, time/fraction schedule:1.8-1.9Gy/F to the 90% isodose line, 1F/D, 5F/W, overall rate:50.4-62.7Gy.Chemotherapy:GP scheme:gemcitabine 700-1000/m2 d1, 8 and Cisplatin 20mg/m²d1-3, GP scheme was applied one cycle at every four weeks and two to five cycles in chemotherapy alone group, and one cycle before and after radiation in 3D-CRT with GP group;FH scheme:5-Fu 500mg/m²and Hcpt 10mg/m² delivered respectively in five days continually, then radiated, when dose achieved 40Gy, the other cycle was given immediately, then radiated again.Results The side effect of 3D-CRT with chemotherapy group was slighter than that of chemotherapy alone group, especially in the FH group.The rate of pain palliation of them were 55% and 20% respectively(P＜0.05)and is higher in the FH group(62%).Five patients experienced partial response and one complete response in the 3D-CRT with chemotherapy group, but partial response was observed in only one patient of the chemotherapy alone group(P＜0.05), and the better effect was observed in the FH group, though without a statistical difference.The median survival from the time of therapy was 12 months in 3D-CRT with chemotherapy group, higher than that of chemotherapy alone group(P＜0.05).The survival rate of 1 year in the former was better, especially in the FH group(P＜0.05).Conclusion The rate of pain palliation was higher in 3D-CRT with chemotherapy group than that of chemotherapy alone group.Better general remission was achieved in the former and the efficacy of the treatment in terms of prolongation of life was proven in the same group, but the side effect was slighter in this group.At the same time, the better effect and slighter toxicity were observed in clinical in the 3D-CRT with FH group than with GP group.

Key words: Pancreatic cancer, Advanced, 3D-CRT, Chemotherapy