多极射频消融治疗不能切除胰腺癌的临床应用研究  

Multi-polar Radiofrequency Ablation in the Treatment of Unresectable Pancreatic Cancer

作　　者：崔忠[1] 杜冬[1] 王振全[1] 崔永泽[1] 魏强[1] 赵清涛[1] 孙建斌[1] 

机构地区：[1]解放军白求恩国际和平医院普外肝胆科,石家庄050082

出　　处：《华北国防医药》2008年第5期7-9,共3页Medical Journal of Beijing Military Region

摘　　要：目的:评估射频消融治疗不能切除胰腺癌的远期疗效。方法:将不能切除的60例进展期胰腺癌随机分为射频消融组和化疗组,每组30例,射频消融组术中接受射频消融治疗,同时行胆道旁路引流和(或)胃肠短路手术。化疗组接受常规化疗(氟尿嘧啶+丝裂霉素+多柔比星),22例合并黄疸者同时行经皮、经肝胆管引流(PTCD)。观察指标:临床受益反应(CBR)、肿瘤局部血运改变及大小改变、肿瘤标志物CEA和CA19-9、黄疸指数、并发症及生存期。结果:CBR整体改善率:射频消融组83.3%,化疗组13.3%,差异有统计学意义(P<0.01)。肿瘤局部血运改变2组比较差异有统计学意义(P<0.01),肿瘤体积变化差异无统计学意义(P>0.05)。治疗后射频消融组肿瘤标志物CEA和CA19-9有效率与化疗组比较,差异具有统计学意义(P<0.01)。射频消融组黄疸指数有效率与化疗组比较,差异具有统计学意义(P<0.01)。射频消融组4例出现胃肠功能差,化疗组4例出现白细胞及血小板降低,3例PTCD引流管脱管。射频消融组和化疗组治疗后中位生存期分别为16.5个月和6.5个月,2组差异具有统计学意义(P<0.01)。结论:射频消融联合胆道旁路引流和(或)胃肠短路术治疗不能切除胰腺癌能够明显提高肿瘤坏死率,显著改善患者远期生存状况和疾病相关症状,是一种安全可行、创伤小、疗效确切的局部治疗方法。Objective：To evaluate the long-term curative effect of the RFA treatment in pancreatic cancer and to find out a safe,mini-invasive local therapy to prolong the survival period and improve the survival quality of advanced pancreatic cancer patients. Methods：60 cases of advanced pancreatic cancer were divided randomly into two groups：RAF group（30 cases） and chemotherapy group（30 cases）. The unreseetable pancreatic cancer patients received RAF during operation combined together with choledochojejunostomy and gastroycjunostomy. 22 patients in the latter group were treated with chemotherapy （5-FU, MMC, ADR） once a month and simultaneously treated with PTCD. The change of clinical benefit response （CBR） ,local change of tumor image, tumor size, levels of serum tumor makers C EA, CA19-9 and jaundice index,complications, and survival time were followed up. Results： All patients showed tolerance to the treatment. The CBR was 83.3% in RAF group and 13.3% in chemotherapy group respectively. The difference was significant（ P 〈 0.01 ）. The level of CEA, C19-9 and jaundice index in RAF group were much lower when compared with that of pre-treatment and of the chemotherapy group. The difference was significant （ P 〈 0.01 ）. Chemotherapy decreased the level of CEA, CA19-9 and jaundice index（ P 〈 O. 01 ）. After RFA, the tumor size did not change （ P 〈 0.05 ）. No complications such as thermal injury,bleeding in the digestive tract and celiac, acute pancreases and pancreatic juice leak appeared in the RAF group with statistical significance（P 〈0. 01 ）. 4 patients felt nausea and discomfort. In the chemotherapy group,4 cases showed bone marrow inhibition,and 3 drainage tube fell off. The mean survival time was 16.5 and 6.5 months in the RAF and chemotherapy group respectively with statistical significance（P 〈 0.01 ）. Concluslon：The use of RFA can significantly increase tumor necrosis rate. It can markedly prolong patient＇s long-term survival and improve disease-related

关 键 词：胰腺肿瘤 进展期 多极射频消融 治疗结果 

分 类 号：R735.9[医药卫生—肿瘤]