125I粒子植入治疗胰腺癌的疗效及治疗前后血清肿瘤标志物的动态变化  

Clinical Efficacy of CT-guided Radioactive 125I-seed Implantation in the Treatment of Pancreatic Cancer and Sequential Changes of Serum Tumor Markers before and after the Treatment

作　　者：陆健[1] 王忠敏[1] 陈克敏[2] 贡桔[1] 郑云峰[1] 李麟荪[3] 

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院放射科,上海200025 [2]上海交通大学医学院附属瑞金医院放射科 [3]江苏省人民医院介入放射科

出　　处：《实用放射学杂志》2011年第3期425-429,共5页Journal of Practical Radiology

基　　金：国家自然科学基金项目（编号：81071281）;上海市自然科学基金项目（编号：10ZR1419800）;上海市卫生局青年科研基金项目（编号：2010010）.

摘　　要：目的 观察CT引导下125I 放射性粒子植入治疗胰腺癌的临床疗效及125I粒子植入前后血清肿瘤标志物的动态水平.方法 对21例不能手术切除的晚期胰腺癌患者施行CT引导下植入125I 放射性粒子.采用治疗计划系统（treatment planning system,TPS）重建胰腺肿瘤的三维立体图像,计算出125I粒子植入的数量和剂量分布率,在CT引导下经皮穿刺,将125I粒子植入胰腺肿瘤内.并用放射免疫方法 测定125I 放射性粒子植入治疗胰腺癌前后的患者血清肿瘤标志物CEA、CA19-9、CA50的浓度.结果治疗后随访1~24个月.全组中位生存时间10个月.125I 粒子植入1月后,胰腺癌患者血清中CEA、CA19-9、CA50等肿瘤标志物水平与植入前比较有明显变化（P＜0.05）.在CA19-9测定结果中,病情进展与植入前,病情完全缓解,部分缓解及病情稳定比较有统计学差异（P＜0.05）.结论 CT引导下植入125I 放射性粒子治疗胰腺癌,临床近期疗效确切,是一种安全、有效、并发症少的介入治疗方法.Objective To evaluate the efficacy of CT-guided 125 iodine seeds implantation in the treatment of pancreatic cancer and the sequential changes of serum tumor markers before and after the treatment. Methods 21 patients with end-stage unresectable pancreatic cancer underwent CT-guided 125 iodine seeds implantation, treatment planning system was used to reconstruct 3-dimentional image of the tumor and to define the quantity and distribution of 125 iodine seeds. 125 iodine seeds were introduced into pancre atic cancer under CT-guided. Serum CEA,CA19-9 and CA50 were detected by radioimmunoassay in pancreatic cancer patients before and after planting . Results All the patients were followed up for 1--24 months . The median survival period for all enrolled patients was 10 months . One month after planting, the levels of serum CEA,CA19-9 and CA50 were induced significantly in all cases （P〈0.05）. There was significant difference in the level of CA19-9 among complete remission, partly remission and statistical disorder compared with before planting（P〈0.05）. Conclusion 125 iodine seeds implantation under CT-guided is a safe, effective,less complicated option in treating advanced pancreatic cancer.

关 键 词：胰腺 胰腺癌 125I粒子 肿瘤标志物 体层摄影术 X线计算机 

分 类 号：R735.9[医药卫生—肿瘤] R815[医药卫生—临床医学]