Beneficio clínico del tratamiento con cannabinoides para el dolor crónico no oncológico

Introducción: los cannabinoides pueden ser una opción válida para el tratamiento del dolor crónico no oncológico de acuerdo a los estudios publicados hasta el momento y a nuestra experiencia clínica. Objetivo: valorar el beneficio clínico de preparados de cannabis medicinal (CM) para dolor crónico no oncológico en pacientes que consultaron en la Clínica de Endocannabinología del Uruguay (CEDU). Material y método: estudio descriptivo, observacional, longitudinal, de una población atendida en un centro privado de salud. Se trata de una cohorte de 438 pacientes que consultaron espontáneamente en CEDU desde septiembre de 2016 a marzo de 2020. El motivo de consulta fue dolor crónico no oncológico que no respondió al tratamiento estándar. Resultados: en la cohorte estudiada predominaron las mujeres (74%), promedio 69 años, que se asisten en el sistema privado de salud en el 95% de los casos, en su mayoría con instrucción secundaria. El tipo de dolor más frecuente fue el dolor osteoarticular. El quimiotipo de CM más usado fue cannabidiol (CBD) al 5%, con buena respuesta al tratamiento en el descenso del nivel del dolor y suspensión o disminución de uso de opioides (y derivados) y antiinflamatorios no esteroideos (AINES). Se observaron escasos y leves efectos adversos (EA) en la gran mayoría de los pacientes. Abandonaron el tratamiento 12 pacientes (menos del 3%). Conclusiones: esta investigación retrospectiva mostró una caída del nivel del dolor de 3,14 (valor p ≤ 0,0001), indicando que el CM puede ser una opción para el tratamiento del dolor crónico no oncológico. Se requieren más estudios para demostrar la efectividad y seguridad de los cannabinoides. Esto depende de muchos factores (leyes que faciliten la accesibilidad a variedad de productos de CM de grado médico, incentivos a la ciencia e investigación). De todas formas, podemos afirmar que los resultados presentados son prometedores en relación con su potencial terapéutico.

Introduction: Cannabinoids can be a valid option for the treatment of chronic non-cancer pain, according to the studies published to date and our clinical experience. Objectives: To evaluate the clinical benefit of medicinal cannabis preparations (MCPs) for chronic non-cancer pain in patients seen at the Endocannabinology Clinic of Uruguay (CEDU). Method: Descriptive, observational, longitudinal study of a population treated at a private healthcare center. This involves a cohort of 438 patients who spontaneously consulted at CEDU from September 2016 to March 2020. The reason for consultation was chronic non-cancer pain that did not respond to standard treatment. Results: in the studied cohort, women prevailed and accounted for 74% of patients. Average age was 69 years old and 95% of them sought care within the private healthcare system. Most women had completed secondary school education. The most frequent type of pain was osteoarticular pain. The most used chemovar of Medicinal Cannabis (MC) was 5% cannabidiol (CBD), showing a favorable treatment response in reducing pain levels and the discontinuation or reduction of opioid and non-steroidal anti-inflammatory drug (NSAID) usage. Few and mild adverse effects (AE) were observed in the vast majority of patients. Twelve patients (less than 3%) discontinued the treatment. Conclusions: This retrospective study demonstrated a reduction in pain level of 3.14 (p-value ≤ 0.0001) indicating that MC could be an option for the treatment of non-oncological chronic pain. Further studies are needed to demonstrate the effectiveness and safety of cannabinoids. This depends on many factors (laws facilitating accessibility to a variety of medical-grade MC products, incentives for science and research). Nevertheless, we can assert that the presented results are promising in consideration of their therapeutic potential.

Introdução: os canabinoides podem ser uma opção válida para o tratamento da dor crônica não oncológica de acordo com estudos publicados até o momento e nossa experiência clínica. Objetivos: avaliar o benefício clínico das preparações de Cannabis Medicinal (CM) para dor crônica não oncológica em pacientes que consultaram a Clínica de Endocanabinologia do Uruguai (CEDU). Método: estudo descritivo, observacional, longitudinal de uma população atendida em um centro de saúde privado. Esta é uma coorte de 438 pacientes que consultaram espontaneamente no CEDU no período setembro de 2016 - março de 2020. O motivo da consulta foi dor crônica não oncológica que não respondeu ao tratamento padrão. Resultados: na coorte estudada, 74% eram mulheres, a idade média foi 69 anos, 95% frequentam a rede privada de saúde e a maioria com ensino médio. O tipo de dor mais frequente foi a osteoarticular. O quimiotipo de MC mais utilizado foi o Canabidiol 5% (CBD), com boa resposta ao tratamento em termos de redução do nível de dor e suspensão ou redução do uso de opioides (e derivados) e anti-inflamatórios não esteroides (AINEs). A grande maioria dos pacientes apresentou poucos e leves efeitos adversos (EAs). Menos de 3% dos 12 pacientes abandonou o tratamento. Conclusões: Esta investigação retrospectiva mostrou uma queda no nível de dor de 3,14 (valor de p ≤ 0,0001), indicando que o MC pode ser uma opção para o tratamento da dor crônica não oncológica. São necessários mais estudos para demonstrar a eficácia e segurança dos canabinoides. Isso depende de muitos fatores (leis que facilitem o acesso a uma variedade de produtos CM de grau médico, incentivos para ciência e pesquisa). De qualquer forma, podemos afirmar que os resultados apresentados são promissores em relação ao seu potencial terapêutico.

A preliminary study on stereotactic ablative brachytherapy for lung metastases from cervical cancer / 中国辐射卫生

Objective To preliminarily study the effectiveness and safety of stereotactic ablative brachytherapy (SABT) for lung metastases from cervical cancer. Methods We analyzed the clinical data of 18 patients with cervical cancer with lung metastasis treated with SABT to compare gross tumor volume (VGTV) and squamous cell carcinoma (SCC) antigen before and after SABT. The clinical benefit rate (CBR) and adverse reactions were recorded. Results After SABT treatment, there were significant decreases in VGTV (t=1.708, P<0.05) and the SCC antigen level (t=1.704, P<0.05). CBR reached 94.4%. Adverse reactions of grades 3-4 did not occur in any patient. Fourteen patients had mild complications, including 1 case of bloody sputum and 1 case of a small pneumothorax. Ten cases developed mild radiation-induced lung injury, with grade 2 radiation pneumonitis in 4 cases. The Karnofsky performance status score and needle depth were not associated with the occurrence of adverse reactions, while the radius of GTV and interstitial lung disease were associated with the occurrence of adverse reactions. Conclusion SABT is a safe and effective alternative to the treatment of lung metastases from cervical cancer.

Improving clinical outcomes through advances in point-of-care testing / 中华检验医学杂志

Point-of-care testing (POCT) systems has been widely used in clinical practice. It is necessary to carefully review and summarize issues related to the testing speed, cost, and quality of POCT. Guidelines and standardization documents for clinical application of POCT need to be formulated as soon as possible. These works would contribute to the accuracy and reliability of POCT results and help the accurate application of POCT in clinical practice.

Clinical application of apatinib mesylate combined with chemotherapy in treatment of patients with advanced breast cancer / 吉林大学学报(医学版)

Objective: To observe the clinical efficacy and safety of apatinib combined with chemotherapy in the patients with advanced breast cancer after failed multi-line therapy, and to clarify the siginificance of apatinib in the treatment of the patients with advanced breast cancer. Methods: Twenty-five patients with advanced breast cancer were treated with multi-line therapy, among them 5 (20%) patients were in the third-line treatment, 7 (28%) patients were in the fourth-line treatment, and 13 (52%) patients were in the fifth-line treatment and above. All patients were treated with apatinib in combination with chemotherapy, and the chemotherapy regimen was selected based on the condition and previous medication. Apatinib 250-500 mg was given orally once a day, until the disease progresses occured or the patients could not tolerate the adverse reactions. The efficacies, including the objective response rate (ORR), the clinical benefit rate (CBR), and progression-free survival (PFS), were evaluated by RECIST 1. 1. The adverse reactions were evaluated by NCI-CTC 4. 0. Results: The median number of treatment lines of the patients with breast cancer was fifth-line, the total ORR was 12% (3/25), the CBR was 52% (18/25), and the median progression-free survival (mPFS) was 6. 00 months. Among the 5 patients with third-line therapy, 2 patients were stable disease (SD) and the CBR was 40% (2/5); among the 7 patients received the fourth-line therapy, 2 patients were partial response (PR), 2 patients were SD, and the CBR was 57% (4/7); among the 13 patients received firth-line therapy, 1 patient was PR, 6 cases were SD, and the CBR was 54% (7/13). According to the pathological type, among 5 patients of triple-negative type, 3 patients were SD, the CBR was 60% (3/5); among 12 patients of Luminal type, 1 patients was PR, 2 patients were SD, and the CBR was 25% (3/12); among 8 patients of HER-2 positive type, there were 2 patients acheived PR, 5 patients acheived SD, and the CBR was 88% (7/8). The short-term efficacy of the patients in 50 years old and over group was better than that of the patients in below 50 years old group (P<0. 05). There were no significant differences in the short-term efficacies between the other factors (PX). 05). Moreover, the patients treated with apatinib combined with chemotherapy had good tolerance, and the main adverse reactions were fatigue, hand-foot syndrome, hepatic insufficiency, hypoproteinemia, anemia, anepi-thymia, hypertension, and proteinuria; mainly in grade 1 or grade 2; the most common adverse reactions were fatigue (80%), hypoproteinemia (60%), hand-foot syndrome (60%), and hepatic insufficiency (60%). Conclusion: Apatinib mesylate combined with chemotherapy is effective in the treatment of the advanced breast cancer patients failed in multi-line therapy and the patients can tolerate the adverse reactions.

New perspectives on cardiovascular benefits of conventional statins and their combination therapy for lipid regulation / 天津医药

Atherosclerotic cardiovascular diseases(ASCVD)are the major causes of morbidity and mortality worldwide. Previous randomized controlled trials confirm that statin therapy can effectively reduce the level of low density lipoprotein cholesterol(LDL-C),all-cause and cardiovascular disease mortality in patients with and without ASCVD.However,there is no widespread use of lipid-lowering therapy to achieve the benefit in high risk patients with ASCVD and patients without ASCVD. Therefore, it is necessary to further elaborate the clinical benefits of statins and their combined use for lipid regulating therapy and increasing the beneficiaries.

Clinical timing and benefit of antiviral treatment for hepatitis C / 中华肝脏病杂志

Current treatments for hepatitis C include pegylated interferon-α (Peg-IFNα) and ribavirin (RBV) combination therapy and direct antiviral agents (DAAs). Antiviral treatment can be initiated after 4 to 6 months of clinical observations for patients with acute infections, but should be started as early as possible for those with chronic infections. However, for patients who are ineligible for Peg-IFN and RBV combination therapy and have no unrestricted access to DAAs, it is advised that they wait for the approval of DAAs in China if their medical condition is under control. Though, antiviral therapy should be started immediately if the disease progresses. It has been reported that there are numerous clinical benefits of antiviral treatment for hepatitis C. However, the long-term impact of DAAs treatment including efficacy and safety is limited and remains to be explored.

Clinical Study on Tiaogan Lipi Huaji Prescription Combined with High Intensity Focused Ultrasound for Treatment of Locally Advanced Pancreatic Cancer / 中国中医药信息杂志

Objective To investigate the effects ofTiaogan Lipi Huaji Prescription combined with high intensity focused ultrasound (HIFU) for the treatment of locally advanced pancreatic cancer.Methods Randomized, parallel controlled study was designed to select 60 patients with locally advanced pancreatic cancer, which were divided into treatment group and control group by random number table method, 30 cases in each group. The treatment group was givenTiaogan Lipi Huaji Prescription, one dose per day, twice a day, orally, 28 d as a treatment course, 6 courses in total; at the same time, HIFU was given to the treatment group, 30–60 min each time, once every other day, 2–3 times each week, and the tumor was completely covered for 2 times. The control group was given gemcitabine 1000 mg/m2, intravenous infusion, 1st, 8th d, 21–28 d for a cycle, a total of 6 cycles. The clinical benefit response, QOL-C30 score, survival status, progression-free survival (PFS), CA199 and CEA levels were observed.Results Clinical benefit rates of treatment group and control group were: the treatment group 1, 3, 6 months clinical benefit rate was 64.29%, 63.16%, and 50.00%, respectively; control group clinical benefit rate was 48.15%, 40.00%, and 44.44%, respectively, with statistical significance (P0.05). CEA levels in the treatment group were lower than those in the control group at the same time with statistical significance (P0.05). The survival time of the treatment group was (253.90±18.06)d in the control group and (246.77±17.31)d in the control group, without statistical significance (P>0.05). PFS was (136.73±16.22)d in the treatment group and (145.77±19.74)d in the control group, without statistical significance (P>0.05).ConclusionTiaogan Lipi Huaji Prescription combined with HIFU for the treatment of locally advanced pancreatic cancer has certain clinical efficacy, which can improve patients' life quality.

Amisulpride Switching in Schizophrenic Patients Who Showed Suboptimal Effect and/or Tolerability to Current Antipsychotics in a Naturalistic Setting: An Explorative Study

OBJECTIVE: Despite numerous atypical antipsychotics (AAP) available, many patients with schizophrenia still experience lack of efficacy and persistent side-effects. Switching from one AAP to another with a different side-effect profile has become a common clinical strategy. We aimed to investigate effect of switching to amisulpride in patients who showed suboptimal effect and/or tolerability to current antipsychotics treatment. METHODS: This was a 6-week, prospective, multicenter, open-label, flexible-dose study in patients with schizophrenia. Switching to amisulpride was achieved using cross-titration within 7 days (day 1: 300 mg on day 1 then flexibly dosed 400–800 mg/day). The primary end-point measure was proportion of patients achieving improvement in clinical benefit at week 6 based on Clinical Global Impressions-Clinical Benefit (CGI-CB). Secondary endpoints included change in scores in CGI-CB, CGI-Severity (CGI-S), Subjective Satisfaction Scores (SSS), Brief Psychiatric Rating Scale (BPRS), and Simpson and Angus Rating Scale. RESULTS: Among 37 patients switched to amisulpride, 76% completed study and 56.8% had clinical benefit measure by CGI-CB. CGI-CB and CGI-S scores showed significant improvement at week 6 compared to baseline (mean changes of CGI-CB and CGI-S scores: −1.7+1.0, p<0.0001 and −0.6±0.0, p=0.001, respectively). SSS scores also improved significantly (mean change: 2.1±2.6, p<0.0001). Mean weight of patients significantly lowered compared to baseline (mean change: −1.2±2.0, p<0.0001). CONCLUSION: Patients with schizophrenia who showed suboptimal efficacy or tolerability with their current antipsychotics and thereby switched to amisulpride resulted in clinical benefit in terms of both improved efficacy and tolerability. The small sample size limits generalizability of the study results.

The Effectiveness Evaluation of Helicopter Ambulance Transport among Neurotrauma Patients in Korea

OBJECTIVE: Helicopter ambulance transport (HAT) is a highly resource-intensive facility that is a well-established part of the trauma transport system in many developed countries. Here, we review the benefit of HAT for neurosurgical patients in Korea. METHODS: This retrospective study followed neurotrauma patients who were transferred by HAT to a single emergency trauma center over a period of 2 years. The clinical benefits of HAT were measured according to the necessity of emergency surgical intervention and the differences in the time taken to transport patients by ground ambulance transport (GAT) and HAT. RESULTS: Ninety-nine patients were transferred to a single university hospital using HAT, of whom 32 were taken to the neurosurgery department. Of these 32 patients, 10 (31.3%) needed neurosurgical intervention, 14 (43.8%) needed non-neurosurgical intervention, 3 (9.4%) required both, and 11 (34.4%) did not require any intervention. The transfer time was faster using HAT than the estimated time needed for GAT, although for a relatively close distance (<50 km) without ground obstacles (mountain or sea) HAT did not improve transfer time. The cost comparison showed that HAT was more expensive than GAT (3,292,000 vs. 84,000 KRW, p<0.001). CONCLUSION: In this Korean-based study, we found that HAT has a clinical benefit for neurotrauma cases involving a transfer from a distant site or an isolated area. A more precise triage for using HAT should be considered to prevent overuse of this expensive transport method.

Effect of antioxidant therapy on hospital stayand complications in patients with early acutepancreatitis: A randomised controlled trial.

Background: Oxidative stress (OS) in acute pancreatitis (AP) has been pathologically linked with the systemic inflammatory response and antioxidant supplementation may have a clinical benefit. Methods : In this prospective, randomised open label, controlled pilot study, patients admitted within 72 hours of onset of pain were randomised to receive either placebo (only standard medical treatment; SMT) or antioxidants (vitamin C 500 mg, N-acetyl cysteine 200 mg 8 hourly and antoxyl forte 1 capsule hourly with standard medical treatment; SMT+AO) daily, following informed consent. Patients with co-morbid illness and pregnancy were excluded. Primary efficacy measures were length of hospital stay and complications whilst secondary measures were biochemical markers of oxidative stress (thiobarbituric acid reactive substances [TBARS] and superoxide dismutase [SOD] and total antioxidant capacity [TAC] and vitamin C) at Days 1, 3 and 7. Results: Of 53 patients, 30 patients were randomised to SMT and 23 patients to SMT+AO. The mean duration of hospital stay in the SMT group (10.3±7 days) was more compared to SMT+AOT (7.2±5 days), but was not statistically significant (p=0.07), complications were similar in the 2 groups. At Day 7, OS was significantly lower in the SMT+AO group when compared with the SMT group (TBARS, p=0.05; SOD, p=0.03) with a significant increase in FRAP and vitamin C (p=0.01). Conclusions: Antioxidant supplementation may decrease the length of hospital stay and complication rate in patients with AP, but a larger clinical trial is needed to support this hypothesis. Further, it decreased the OS and improved the antioxidant status in patients with AP.

Gemcitabine and Infusional 5-Fluorouracil in Advanced Pancreatic Cancer: A Clinical Benefit Response-Oriented Phase II Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Gemcitabine and 5-fluorouracil (5-FU) are two compounds with reproducible activity against advanced pancreatic carcinomas. To evaluate the activity and feasibility of this combination chemotherapy, a multi-institutional phase II study was performed. MATERIALS AND METHODS: Twenty patients (male: female 15: 5, median age: 60.5 years), with histologically verified locally advanced or metastatic pancreatic carcinomas, were enrolled between April 2000 and March 2002. Gemcitabine was administered by intravenous injection at the doses of 1, 000 mg/m2 on days 1, 8 and 15, and 5-FU 800 mg/m2/day, was given by continuous intravenous infusion on days 1~5. The treatment was repeated every 4 weeks. The clinical benefit response (CBR) was a composite of the pain, Karnofsky performance status and body weight change measurement. RESULTS: Nineteen of the twenty patients were assessable for response. The median follow-up duration was 4.6 months (0.4~15.2 months). Five patients achieved a partial response and eight a stable disease. The overall response rate was 25.0%. The CBR was assessable in 12 patients. The overall CBR was 41.7% (5/12). The median survival of all the patients was 8.0 months. Grade 3~4 toxicities included neutropenia (9.3%) and thrombocytopenia (5.3%). CONCLUSION: This study suggested that gemcitabine, combined with infusional 5-FU, was well tolerated, and produced modest antitumor activity and symptomatic relief in advanced pancreatic cancer patients.

Gemcitabine single-agent in the treatment of elderly advanced cancer / 中国癌症杂志

Purpose:To evaluate the clinical efficacy ,clinical-benefit-response (CBR) and toxicity of gemcitabine single-agent in the treatment of elderly advanced cancer. Methods:54 elderly patients with grade Ⅲ/Ⅳ were treaded with gemcitabine 1 000 mg/m~(2) on day 1,8 and 15 in each 28-day cycle. The clinical efficacy and toxicity were estimated according to the standard of WHO and the CBR was evaluated simultaneously. Results:Of 32 advanced NSCLC patients , obtained the partial response (PR) of 21.88% .The CBR rate of 90.7% was reached in 54 patients. The toxicity was mild and well tolerated for elderly patients. Conclusions:Gemcitabine single-agent in the treatment of elderly advanced cancer is highly effective, low toxic and safe. Therefore, it could be considered as first line therapy for elderly advanced cancer.

Treatment of advanced pancreatic cance with gemcitabine,5-FU and cisplatine / 中国癌症杂志

Purpose:To observe the curative effect and the clinical-benefit-response of patients with advanced pancreatic cancer who used a combine of Gemcitabine,5-FU and PDD.Methods:The treatment with Gemcitabine (800 mg/m 2) was followed by 5-FU(600 mg/m 2) and DDP (30 mg/m 2),administered on days 1,8 and 15 of 28-day schedule. The curative effect was estimated according to the standard of WHO and the clinical benefit response was evaluated at the same time. The standard of CBR included pain,physical states and body weight. Results:Twenty-five (25/29) patients received over two cycles chemotherapy. 6(24%) partial response (PR), 12 (48%) stable disease and 7(28%) progressive disease were observed. According to the standard of CBR, 18(62.1%) patients achieved the clinical-benefit-response level. Therapy was well tolerated. The main toxicities included that the alimentary tract reactions and the marrow depression. Grade 3-4 thrombocytopenia was reported in 8 (27.6%) patients. Conclusions:The combination of GEM, 5-FU and DDP is a moderatedly active treatment with tolerable side-effects. It has definite response rate and high CBR rate in pancreatic cancer.

Clinical benefit of gemcitabine plus cisplatin 3-week regimen for patients with advanced non-small-cell lung cancer (NSCLC): a prospective observational study / 中国癌症杂志

Purpose:To study the effectiveness and safety o f first-line chemotherapy with GEM-Cis 3-week regimen in routine care of Chin ese patients with advanced NSCLC. Methods:Gem-Cis 3-week regimen was used as first line chemoth erapy to treat stage Ⅲb/Ⅳ NSCLC patients, measurements of effectiveness includ ed clinical benefit and significant clinical response (SCR), and side events of GEM-Cis in the treatment of stage Ⅲb/IV NSCLC. Results:221 patients with cytological or pathological confirmed stage Ⅲb or IV NSCLC were enrolled, 209 eligible for effectiveness and safety analysis. Median age 58 years (range, 29 to 79 years); males: females, 67.5%∶ 32.5%; stage Ⅳ: ⅢB, 52.5%∶47.8 %; KPS

The clinical benefit of CPT-11 combined with 5-FU/CF for patients with locally advanced or metastatic colorectal cancer / 中国癌症杂志

Background and purpose:Irinotecan(CPT-11) is a derivative of camptothecin,an inhibitor of DNA topoisomerase I.CPT-11 is oxidized to inactivated metabolites(including APC)by CyP3A enzymes and activated to SN-38 by Carboxylesterase-2(CES-2).CPT-11 has been shown to exhibit excellent antitumor activity against colorectal cancer.Our research is to evaluate the efficacy and toxicity of CPT-11 combined with 5-FU/CF in the treatment of advanced or metastatic colorectal cancer.Methods:thirty-two cases of advanced or metastatic colorectal cancer patients were treated,and thirty cases were evaluable for efficacy.of which 19 cases were grouped with one cycle every two weeks and 13 cases were grouped with one cycle every three weeks.Results:In 30 evaluable patients,2 cases had complete response,11 cases had partial response,14 cases had stable disease and 3 cases with progressive disease.The response rate of the whole group was 43.3% and the stability rate was 46.7%.The clinical beneficial response rate was 83.3%.Median time to progression was 7.2 months and median overall survival time was 13.8 months. Dose limiting toxicity was delayed diarrhea and neutropenia.There was no death during the treatment.Conclusions:CPT-11 combined with 5-Fu/CF is an effective and well tolerated regimen in the treatment of advanced or metastatic colorectal cancer.which can relieve symptoms and improve quality of life of the patients.It can be used as the first-line or second-line therapy for advanced or metastatic colorectal cancer.

Radiochemotherapy combined with continuous infusional gemcitabine for locally advanced unresectable pancreatic adenocarcinoma / 重庆医科大学学报

Objective:To evaluate the curative efficacy,clinical benefit response (CBR),survival length and toxicity of radiochemotherapy combined with 24 hours continuous infusional gemcitabine for locally advanced unresectable pancreatic adenocarcinoma.Methods:20 patients with histologically or cytologically confirmed locally advanced unresectable pancreatic adenocarcinoma were enrolled into this trial,all of whom had bidimensionally measurable disease that could be assessed by radiographic procedures.Gemcitabine was administered as a 24 hours continuous infusion once weekly for 3 of 4 weeks.Radiation therapy was 3 dimensional conformal radiation therapy (3DCRT),using megavolt irradiation(total dose,45Gy,1.8/Gy/day) of 6MV photons or greater with a 3 or 4-field technique which was delivered concurrently for 5 weeks.Results:Only 2 partial response was observed(10%),and disease was stabilized in 13 additional patients(65%).The median time to progression was 6.5 months (range, 2～13 months).Although all patients developed distant metastases,locoregional failure occurred in only 4.The median survival time was 9.6months (range,3～23.0~+months),and 1-year survival rate was 14.3%.Positive CBR was 14/17(82.4%).The main side effects included slight liver function damage and neutropenia,thrombocytopenia,hypochromia.Conclusion:Gemcitabine when given as prolonged infusion in 130mg/m~2/week combined with 3DCRT is feasible and effective for local control of pancreatic cancer and CBR,but essentially ineffective in counteracting metastatic tumor growth.