动脉灌注吉西他滨联合^(125)I粒子胰腺内植入治疗进展期胰腺癌  

^(125)I implantation combined with Gemcitabine in the treatment of advanced pancreatic cancer

作　　者：李玉亮[1] 王永正[1] 王晓华[1] 张福君[2] 朱立东 张万明[1] 李征[1] 李振家[4] 张开贤[5] 

机构地区：[1]山东大学第二医院介入科,山东济南250033 [2]中山大学附属肿瘤医院介入科,广东广州510060 [3]临沂市肿瘤医院普外科,山东临沂276001 [4]山东省医学影像学研究所,山东济南250021 [5]滕州市人民医院肿瘤科,山东滕州277500

出　　处：《山东大学学报（医学版）》2007年第4期393-396,共4页Journal of Shandong University:Health Sciences

摘　　要：目的:探讨动脉灌注吉西他滨联合125I粒子植入治疗进展期胰腺癌的临床价值。方法:43例进展期胰腺癌(APC)患者随机分成125I粒子植入+吉西他滨(GEM)治疗组(A组,n=18)和单纯吉西他滨化疗组(B组,n=25)。采用改良Dimension-averaging法计算相关放疗剂量。A组8例放置胆道支架解除黄疸,2例放置十二指肠支架解除十二指肠梗阻;B组15例行胆肠和/或胃肠吻合术,5例行ERCP解除黄疸。结果:CR+PR率A组为61.1%,B组为32.0%(P<0.05)。临床受益反应率A组为72.2%,B组为40.0%(P<0.05)。3、6、12、18个月生存率A组为100%、94.4%、72.2%、61.1%,B组为100%、76.0%、32.0%、12.0%(P<0.05)。结论:125I+GEM能缓解疼痛,改善APC患者的生存质量,提高生存率。Objective： To study the role of ^125I implantation plus gemcitabine in treatment of advanced pancreatic cancer（APC）. Methods： Forty-three untreated patients with APC were randomly divided into two groups： ^125I plus gemcitabine （group A, n = 18）and Gemcitabine（group B,n = 25）. The total activity and number of ^125I seeds used were as recommended by the improving dimension-averaging. In group A, 8 patients were treated with stents to release jaundice and 2 patients with duodenal stents placement to release the duodenal obstruction. In group B, 15 patients underwent laparotomy and 5 underwent endoscopic retrpgrade cholangio-pancreatography （ERCP）. Results： Overall respouse rate（CR ＋ PR）in group A and in group B was 61.1% and 32.0% respectively（ P 〈 0.05）. Clinical benefit respouse was experienced by 72.2% of group A compared with 40.0% of group B（ P 〈 0.05）. The survival rates of 3, 6, 12 and 18 months were 100%, 94.4%, 72.2% and 61.1% for group A and 100%, 76.0%, 32.0% and 12.0% for group B （ P 〈 0.05）. Conclusion： ^125I plus GEM is effective in easing pain, improving the health-related quality of life, and prolonging the life of patients.

关 键 词：^125碘 胰腺肿瘤 吉西他滨 

分 类 号：R735.9[医药卫生—肿瘤]