放射性125^I粒子组织间植入治疗胰腺癌的疗效分析  

Therapeutic analysis of interstitial implantation with ^(125)I seeds in the treatment of pancreatic cancer

作　　者：张长宝[1] 田建明[1] 吕桃珍[1] 左长京[1] 邵成伟[1] 生晶[1] 

机构地区：[1]上海第二军医大学长海医院放射科,200433

出　　处：《介入放射学杂志》2009年第4期281-284,共4页Journal of Interventional Radiology

基　　金：上海市领军人才培养基金(LJ06006);上海市科委临床医学重点项目(054119637)

摘　　要：目的探讨125I粒子组织间植入治疗胰腺癌的疗效。方法回顾性分析2005年7月至2008年6月我院采用125I粒子植入治疗的33例胰腺癌患者资料。肿瘤最大径1.5～6.6cm,平均3.7cm。结果粒子植入术后,止痛有效率为60.6%,术后3个月内4例死亡。术后3个月CT复查,部分缓解(PR)8例,疾病稳定(SD)13例,疾病进展(PD)8例,总有效率27.6%。全组生存时间2～19个月,中位生存时间5.1个月,6例仍在随访中。随访中无胰瘘和胃肠道出血等严重并发症,有51粒粒子(18例患者)丢失,11粒粒子(5例患者)出现迁移,移至肠道9粒,肝、脾各1粒,未见放射性肠炎和肝功能改变。结论125I粒子组织间植入治疗胰腺癌在疼痛缓解方面疗效明确,但本组病例Ⅳ期患者较多,未取得较好的疗效,具体疗效还有待于大样本前瞻性队列研究证实。Objective To assess the therapeutic effect of interstitial implantation with 125^I seeds in treating pancreatic cancer. Methods During the period of July 2005 - June 2008, interstitial implantation with 125^I seeds was performed in 33 patients （22 males and 11 females, mean age 64） with pancreatic cancer. The maximum diameter of the tumor was 1.5 - 6.6 cm （mean 3.7 cm）. The clinical data were retrospectively analyzed. Results The pain relief rate was 60.6%. Four patients died within 3 months. CT re-exam 3 months after the treatment showed that partial response was observed in 8, stabilization in 13 and deterioration in 8 patients. The overall effective rate was 27.6%. No serious complications, such as pancreatic leakage, gastrointestinal hemorrhage, etc. occurred. The median survival time was 5.1 months. In 18 patients, 51 seeds were missing. In 5 patients,11 seeds were migrated, of which 9 moved to intestine, one to liver and one to spleen. Neither radiation enteritis nor hepatic dysfunction developed. Conclusion In the treatment of pancreatic cancer, interstitial implantation with 125^I seeds is very effective in reliving pain, however, a part of patients in staging Ⅳ enrolled in this study respond poorly to the treatment. Therefore, a prospective cohort study with a large sample is required to further verify the efficacy of the treatment.

关 键 词：胰腺癌 近距离放射疗法 125I粒子植入 

分 类 号：R735.9[医药卫生—肿瘤]