经皮肝胆管穿刺引流术后卡培他滨联合调强放疗治疗胆管癌所致阻塞性黄疸的临床研究  

A Clinical Study on Capecitabine Combined with IMRT plus Percutaneous Bile Duct Puncture in the Treatment of Bile Duct Cancer-Induced Obstructive Jaundice

作　　者：王书山[1] 李瑞卿[1] 叶静[1] 周长杰[1] 

机构地区：[1]泰安市肿瘤医院放疗科,山东泰安271000

出　　处：《肿瘤药学》2016年第5期366-369,共4页Anti-Tumor Pharmacy

摘　　要：目的评价经皮肝胆管穿刺术(PTCD)后卡培他滨(Cap)联合调强放疗(IMRT)治疗胆管癌所致阻塞性黄疸的疗效。方法选取2011年3月至2014年5月于我科就诊的42例胆管癌所致阻塞性黄疸患者,随机分为两组,各21例。研究组治疗方案为PTCD+Cap+IMRT,对照组为PTCD+IMRT,观察并比较两组的疗效。结果研究组的有效率为80.9%,明显高于对照组的66.7%(P<0.05)。研究组6、12、18个月生存率分别为80.95%(17/21)、57.14%(12/21)、38.10%(8/21),对照组为71.43%(15/21)、47.62%(10/21)、14.28%(3/21)。两组6、12个月的生存率差异无统计学意义(P>0.05),但研究组18个月生存率显著高于对照组(P<0.05)。两组胃肠道反应、骨髓抑制等不良反应发生率的差异无统计学意义(P>0.05)。结论经皮肝胆管穿刺并卡培他滨联合调强放疗方法治疗胆管癌所致阻塞性黄疸的有效率高于经皮肝胆管穿刺联合调强放疗,具有一定的临床应用价值。Objective To evaluate the clinical effect of capecitabine（Cap） combined with intensity modulated radiation therapy（IMRT） on bile duct cancer-induced obstructive jaundice（MOJ） after percutaneous bile duct puncture（PTCD）. Methods In this study, 42 patients with malignant obstructive jaundice due to bile duct cancer in our hospital bewteen March 2011 and May 2014 were randomly divided into two groups, 21 cases in each group. The treatment method of the study group was PTCD＋Cap＋IMRT, while it was PTCD＋IMRT in the control group. The curative effects were observed and compared between the two groups. Results The study group achieved a high effective rate of 80.9%, which was significantly higher than that of the control group of 66.7%（P〈0.05）. The survival rates of the study group were respectively 80.95%（17/21）, 57.14%（12/21） and 38.10%（8/21） at 6 months, 12 months and 18 months after treatment. Whereas the survival rates were respectively 71.43%（15/21）, 47.62%（10/21） and 14.28%（3/21） in the control group. There were no significant differences in the survival rate at 6th and 12 th month between the two groups（P〉0.05）, but the survival rate at 18 th month was significantly higher in the study group than in the control group（P〈0.05）. The adverse reactions, such as gastrointestinal reaction and bone marrow suppression, had no statistical differences between the two groups（P〉0.05）. Conclusion By using the method of percutaneous puncture, capecitabine combined with intensity modulated radiation therapy could significantly relieve the symptoms of jaundice, and achieve a better effect on patients with malignant obstructive jaundice. This method deserves clinical application.

关 键 词：胆管穿刺 卡培他滨 调强放疗 胆管癌 阻塞性黄疸 

分 类 号：R735.8[医药卫生—肿瘤] R730.6[医药卫生—临床医学]