^125Ⅰ粒子组织间插置治疗贲门癌的远期疗效  

Long-term effects of radical resection plus interstitial implantation of ^125Ⅰ radioactive seeds in the treatment of cancer of the cardia

作　　者：张继军[1] 梁彦[1] 高翔[1] 程晓斌[1] 莫晓潮[1] 

机构地区：[1]镇江解放军第三五九医院胸外科,江苏212001

出　　处：《中华胸心血管外科杂志》2009年第1期26-28,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨贲门癌根治术中组织间插置^125Ⅰ粒子治疗贲门癌的临床价值。方法118例贲门癌病人施行根治性手术，其中根治性手术加^125Ⅰ粒子插置组（A组）57例，单纯根治性手术组（B组）61例。对两组病人的3,5年生存率，以及术后并发症的发生率和病死率进行对照分析。结果根治性手术加^125Ⅰ粒子插置组3、5年生存率分别为59．6％、49．1％，明显高于单纯根治性手术组的41．0％、31．1％，两组比较差异有统计学意义（X^2=4．072、P〈0．05，X^2=3．939、P〈0．05）。根治性手术加^125Ⅰ粒子插置组术后并发症的发生率和病死率分别为8．8％、1．8％，单纯根治性手术组分别为6．6％、3．3％，两组比较差异无统计学意义（X^2=0．111、P〉0．05，X^2=0．333、P〉0．05）。结论贲门癌根治术中组织间插置^125Ⅰ粒子治疗贲门癌可明显提高远期疗效，与单纯根治性手术相比并不增加术后并发症的发生率和病死率，是一种安全提高有效治疗效果的手术方法。Objective To evaluate the long-term effect of interstitial implantation of radioactive iodine-125 （^125Ⅰ） seeds as an adjunctive technique to the radical resection in the treatment of cancer of the eardia. Methods From March 2001 to March 2003, one hundred and eighteen patients with cancer of the cardia underwent radical resection in our department. Fifty-seven patients （group A） were treated with radical resection plus interstitial implantation of radioactive ^125Ⅰ seeds during surgery, and 61 patients （group B） were treated with radical resection along. The rate of 3-year and 5-year survival, postoperative complications and mortality were compared between the two groups. Results The demographic data of the two groups were comparable, as well as metastatic status of the lymph nodes, cancer staging, and the type of operation. One hundred and thirteen patients were followed for 5 years. The overall rate of follow up was 95.8 %, 96.5 % in group A and 95.1% in group B. The differences in the rates of 3-year and 5-year survival between group A （59.6% and 49.1% ） and group B （41.0% and 31.1% ） were statistically significant （ X^2 = 4.072, P 〈 0. 05, for the rate of 3-year survival; X^2 = 3.939, P 〈 0.05, for the rate of 5-year survival）. Postoperative complications, including anastomotic stricture, pancreatic fistula, anastomotic leakage, ileus and pulmonary infection, occurred in 5 patients of group A and in 4 patients of group B. Three patients died postoperatively, 1 in group A and 2 in group B. The differences in the rates of postoperative complications and mortality between group A （8.8 % and 1. 8 % ） and group B （6.6 % and 3.3 % ） were not statistically significant （ X^2 = 0.111, P 〉 0.05, for the rate of postoperative complications; X^2 = 0.333, P 〉 0.05, for the mortality rate）. There were 26 and 37 deaths in group A and B respectively. Six deaths in group A and 13 deaths in group B were attributed to local recurrence, and 17 deaths in group A and 21 deaths in gr

关 键 词：贲门 肿瘤 外科手术 治疗结果 碘同位素 

分 类 号：R686[医药卫生—骨科学]