B超引导下术中^125I粒子植入治疗晚期胰腺癌的疗效评价  

Evaluation of ^125I particle implantation in the treatment of patients with advanced pancreatic neoplasms using B ultrasound-guided surgery

作　　者：徐蓉生[1] 梅艳[1] 赵力威[1] 舒斌[1] 何文果[1] 段云[1] 

机构地区：[1]四川省肿瘤医院核医学科,成都610041

出　　处：《国际放射医学核医学杂志》2016年第6期424-428,共5页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的 探讨B超引导下125I粒子组织间植入治疗晚期胰腺癌的临床价值。方法 97例晚期胰腺癌患者在B超引导下术中植入125I粒子，采用疼痛数字分级法、实体瘤的疗效评价标准和肿瘤标志物糖类抗原242、19-9（CA242、CA19-9）的水平进行疗效评价，随访中观察患者的并发症及不良反应等。结果 术前与术后1周、2周、1个月、3个月的患者疼痛评分比较，差异具有统计学意义（χ^2=0.018、0.022、0.034、0.045，P均〈0.05）；肿瘤完全缓解患者8例、部分缓解46例、稳定34例、疾病进展9例，总有效率为55.67%（54/97）；术前与术后1个月、3个月CA242、CA19-9的水平比较，差异具有统计学意义（χ^2=0.027、0.029、0.017、0.022，P均〈0.05）；治疗后中位生存时间为（8.0±4.5）个月，未出现严重并发症及不良反应。结论 B超引导下125I粒子植入治疗晚期胰腺癌，疗效确切，安全性高，癌痛缓解明显。Objective To investigate the clinical value of 125I radioactive seed interstitial implantation in the treatment of advanced pancreatic cancer. Methods The pain classification, solid tumor response evaluation criteria, and tumor markers（carbohydrate antigen CA242 and CA19-9） were examined in 97 patients with advanced pancreatic cancer by using ultrasound-guided 125I particle implantation surgery to evaluate the complications and adverse reactions of the tool. Results Comparison among preoperative state, 1 week, 2 weeks, 1 month and 3 months post-surgery revealed significant differences in pain scores（χ^2=0.018, 0.022, 0.034, 0.045, all P〈0.05）; 8 cases had complete remission, 46 cases had partial remission, 34 cases were stable, and 9 cases progressed. The total effectiveness rate was 55.67%（54/97）; moreover, comparison among the preoperative state, 1 month, and 3 months post-surgery indicated significant differences in the serum levels of CA19-9 and CA242（χ^2=0.027, 0.029, 0.017, 0.022, all P〈0.05）. After treatment, the median survival time was（8.0±4.5） months. No serious complications and adverse reactions were observed. Conclusion 125I radioactive particle implantation for the treatment of advanced pancreatic cancer using ultrasound-guided surgery had curative effects, high safety, and significant pain relief.

关 键 词：胰腺肿瘤 碘放射性同位素 近距离放射疗法 实体肿瘤疗效评价标准 

分 类 号：R735.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]