胆汁内引流联合^(125)I粒子治疗伴有梗阻性黄疸的胰腺癌  

Internal biliary drainage combined with ^(125)I seeds implantation for pancreatic cancer with obstructive jaundice

作　　者：罗开发 苏璇[1] 蔡逢春[1] 李闻[1] 

机构地区：[1]解放军总医院消化内科,北京100853

出　　处：《胃肠病学和肝病学杂志》2014年第4期452-455,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨胆汁内引流联合125I粒子植入术治疗中晚期胰腺癌伴梗阻性黄疸的疗效和临床价值。方法选取2006年2月-2012年10月纳入的47例胰腺癌伴梗阻性黄疸患者,分为胆汁内引流组(A组)和胆汁内引流联合125I粒子治疗组(B组),比较A、B两组患者治疗后总胆红素变化、肿瘤体积变化、十二指肠出现梗阻时间以及两组患者的生存期差异。结果 A、B两组治疗前后总胆红素均明显下降,但组间差异无统计学意义(P=0.065)。治疗前后对比,A组肿瘤体积无变化(P=0.111),B组肿瘤体积明显减小(P=0.033),两组之间体积大小变化差异有统计学意义(P<0.001);B组出现十二指肠梗阻较A组晚1.63个月(6.68个月vs 5.05个月,P=0.017)。A组经治疗后6、8个月累计生存率分别为83.1%、21.9%,中位生存时间为6.8个月;B组经治疗后6、8个月累计生存率分别为85.2%、50.1%,中位生存时间为8.2个月,两者间的差异有显著统计学意义(Log-rank值为4.459,P=0.035)。结论胆汁内引流术联合125I粒子植入治疗胰腺癌伴梗阻性黄疸可以解除黄疸、抑制肿瘤的生长、减缓十二指肠梗阻、延长患者生存时间,提高患者的生活质量。Objective To explore the clinical value and efficacy of internal bile drainage combined with 125I seed implantation treatment for advanced pancreatic cancer with obstructive jaundice. Methods From Feb. 2006 to Oct. 2012, 47 patients with advanced pancreatic cancers with obstructive jaundice were divided into group of internal biliary drain- age （group A） and group of internal biliary drainage combined with ~25I seeds implantation （group B）. The serum total bilirubin, size of tumor, duodenal obstruction occurring and survival period were observed. Results The serum total bil- irubin was improved significantly in both groups and no difference was found between two groups （ P = 0. 065 ）. Group A didn＇ t change in size of tumor after treatment （ P = 0.111 ）, but which changed significantly in group B （P = 0. 033 ）, and the size of tumor after treatment between two groups showed significant difference （P 〈 0. 001 ）. The time of duode- nal obstruction was later 1.63 months in group B than group A （6.68 months vs 5.05 months, P = 0. 017）. The 6-, 8- months survival rates were 83.1% , 21.9% respectively in group A and 85.2% , 50.1% respectively in group B （Log- rank value was 4. 459, P = 0. 035）. Conclusion For those who suffered from advanced pancreatic cancer with obstruc- tive jaundice, internal bile drainage combined with 125I seeds implantation can relieve jaundice, inhibit tumor growth, slow duodenal obstruction, prolong survival time and improve the patient＇ s quality of life.

关 键 词：125 I粒子植入 局部放射治疗 胆汁内引流术 梗阻性黄疸 胰腺癌 

分 类 号：R735.9[医药卫生—肿瘤]