腹腔神经丛阻滞术联合^(125)I粒子组织间植入治疗晚期胰腺癌的近期疗效  

Short-Term Efficacy of Celiac Plexus Block Combined with Interstitial Permanent Implantation of ^(125)I Seeds in Treatment of Advanced Pancreatic Cancer

作　　者：柯尊乾 尹志红 周冬 朱晓东[1] 聂豪 胡水红 曾勇 邹佳华 KE Zunqian;YIN Zhihong;ZHOU Dong;ZHU Xiaodong;NIE Hao;HU Shuihong;ZENG Yong;ZOU Jiahua(Cancer Center,The Central Hospital of Huanggang,Huanggang 438021,China;Hubei Clinical Medical Research Center of Esophageal and Gastric Malignancy,Huanggang 438021,China)

机构地区：[1]黄冈市中心医院肿瘤中心,黄冈438021 [2]湖北省食管和胃恶性肿瘤临床研究中心,黄冈438021

出　　处：《肿瘤防治研究》2024年第7期583-587,共5页Cancer Research on Prevention and Treatment

基　　金：黄冈市科技创新专项(YBXM20220006)。

摘　　要：目的探讨腹腔神经丛阻滞术联合^(125)I粒子组织间植入治疗晚期胰腺癌(不可手术切除的局部晚期和转移性胰腺癌)的近期疗效。方法选取100例CT引导下^(125)I粒子组织间植入联合腹腔神经丛阻滞术治疗的晚期胰腺癌患者作为研究对象。术后第7天、1个月和3个月评估疼痛缓解情况和肿瘤标志物CA19-9的变化以及术后3个月通过CT评估肿瘤大小的变化。结果100例患者术后三个月,完全缓解(CR)12例,部分缓解(PR)78例,疾病稳定(SD)5例,疾病进展(PD)5例。CA19-9明显下降(P<0.01),肿瘤长短径之和明显缩小(P<0.01)。治疗前100例患者均属重度疼痛(视觉疼痛模拟量表(VAS):7~10分),术后3个月有59例患者疼痛消失(VAS:0分),35例患者轻度疼痛(VAS:1~3分),6例患者中度疼痛(VAS:4~6分),疼痛缓解率100%。结论腹腔神经丛阻滞术联合^(125)I粒子组织间植入对晚期胰腺癌患者的近期疗效较好且能有效改善患者近期疼痛。Objective To investigate the short-term efficacy of celiac plexus block combined with the interstitial permanent implantation of ^(125)I seeds in the treatment of advanced pancreatic cancer(inoperable locally advanced and metastatic pancreatic cancers).Methods A total of 100 patients with advanced pancreatic cancer were selected and treated with celiac plexus block combined with the interstitial permanent implantation of ^(125)I seeds under CT guidance.Pain relief and changes in the tumor marker CA19-9 were assessed on the seventh day,the first and third months after surgery.In the third month after surgery,tumor size was assessed by CT.Results Among the 100 patients with advanced pancreatic cancer,complete response(CR)was found in 12 cases,partial response(PR)in 78 cases,stable disease in five cases,and progression of disease in five cases three months after surgery.The CA19-9 level and the sum of short and long tumor diameters were significantly decreased(both P<0.01).A total of 100 patients had severe pain before treatment(visual analogue scale(VAS):7–10 points),59 patients reported pain disappearance(VAS:0 points),35 patients had mild pain(VAS:1–3 points),and six patients experienced moderate pain(VAS:4–6 points)in the third month after treatment.The pain relief rate was 100%.Conclusion Celiac plexus block combined with the interstitial permanent implantation of ^(125)I seeds has good short-term efficacy and can effectively improve short-term pain in patients with advanced pancreatic cancer.

关 键 词：胰腺癌 腹腔神经丛阻滞术 ^(125)I粒子 

分 类 号：R735.9[医药卫生—肿瘤]