^(125)I粒子植入联合区域性动脉灌注化疗对中晚期胰腺癌的临床疗效  

Clinical efficacy of ^(125)I seed implantation combined with regional intraarterial infusion chemotherapy in the treatment of advanced pancreatic cancer

作　　者：徐蓓蓓 鲁东 吕维富 肖景坤 张行明 张正峰 周春泽 柴杰 XU Beibei;LU Dong;LYU Weifu;XIAO Jingkun;ZHANG Xingming;ZHANG Zhengfeng;ZHOU Chunze;CHAI Jie(School of Graduate,Bengbu Medical College,Bengbu,Anhui Province 233030,China)

机构地区：[1]蚌埠医学院研究生院,安徽233030 [2]中国科学技术大学附属第一医院介入放射科

出　　处：《介入放射学杂志》2022年第8期770-774,共5页Journal of Interventional Radiology

基　　金：安徽省重点研究与开发计划项目(201904a07020091)。

摘　　要：目的评价I粒子植入联合区域性动脉灌注化疗(RIAC)对中晚期胰腺癌的临床疗效。方法回顾性分析256例Ⅲ、Ⅳ期胰腺癌患者,其中接受I粒子植入联合RIAC(A组)90例,单纯RIAC(B组)68例,全身静脉化疗(C组)98例,观察3组治疗方式的疼痛缓解情况、术后不良反应,比较客观缓解率(ORR)、无进展生存期(PFS)、中位生存时间(mST)和总生存率(OS)。结果治疗后1个月疼痛缓解率在A、B、C组分别为81.11%(73/90)、50%(34/68)、19.39%(19/98),差异有统计学意义(χ^(2)=71.534,P<0.01)。治疗后2个月评估疗效,ORR分别为48.89%(44/90)、33.82%(23/68)、19.39%(19/98),差异有统计学意义(χ^(2)=18.305,P<0.01);mPFS分别为9.5个月、6.9个月、4.9个月,mST分别为13.0个月、10.1个月、7.2个月。A组m PFS和mST均较B、C组延长(χ^(2)=27.638、37.891,P<0.01)。治疗后6、12个月OS,A组分别为86.7%、56.7%;B组分别为75.0%、29.4%;C组分别为59.2%、17.3%。A组患者术后出现粒子迁移7例(7.78%),急性胰腺炎3例(3.33%),未出现新增的严重并发症。结论与单纯RIAC和全身静脉化疗相比,^(125)I粒子植入联合RIAC能改善患者生存质量,延长患者生存时间。Objective To evaluate the clinical efficacy ofI seed implantation combined with regional intraarterial infusion chemotherapy(RIAC)in the treatment of advanced pancreatic cancer.Methods The clinical data of 256 patients with stageⅢorⅣpancreatic cancer were retrospectively analyzed.The patients were divided into group A(receivingI seed implantation plus RIAC,n=90),group B(receiving RIAC only,n=68),and group C(receiving systemic intravenous chemotherapy,n=98).The pain relief,postoperative adverse reactions,objective remission rate(ORR),median progression-free survival(mPFS),median survival time(mST),and overall survival(OS)were compared between each other among the three groups.Results Postoperative onemonth pain relief rate in group A was 81.11%(73/90),which was higher than 50%(34/68)in group B and higher than 19.39%(19/98)in group C,the difference was statistically significant(χ^(2)=71.534,P<0.01).Two months after treatment,the ORR in group A,B and C was 48.89%(44/90),33.82%(23/68)and 19.39%(19/98)respectively,and the difference was statistically significant(χ^(2)=18.305,P<0.01).In group A,B and C,the mPFS were 9.5 months,6.9 months and 4.9 months respectively and the mST were 13.0 months,10.1 months and 7.2 months respectively.Both mPFS and mST in group A were longer than those in group B and in group C(χ^(2)=27.638,P<0.01 andχ^(2)=37.891,P<0.01,respectively).Postoperative 6-month and 12-month OS in group A were 86.7%and 56.7%respectively,which in group B were 75.0%and 29.4%respectively and in group C were 59.2%and 17.3%respectively.In group A,seed migration was observed in 7 patients(7.78%),acute pancreatitis occurred in 3 patients(3.33%),and no newly-developed serious complication was seen.Conclusion Compared with simple RIAC and systemic intravenous chemotherapy,^(125)I seed implantation combined with RIAC can improve the quality of life and prolong the survival time of patients.

关 键 词：胰腺癌 ^(125)I粒子 组织间内照射 区域性动脉灌注化疗 介入治疗 

分 类 号：R735.9[医药卫生—肿瘤]