内镜下肝外胆管癌及壶腹癌~125Ⅰ粒子置入腔内持续照射方法研究

A trial of ~125Iodine brachytherapy on cholangiocarcinoma and carcinoma of ampulla

目的探讨晚期肝外胆管癌及壶腹癌采用^(125)I 粒子置入治疗的方法和价值。方法 12例经 B 超、CT、磁共振检查确诊或拟诊为肝外胆管癌及壶腹癌的患者,采用十二指肠镜行 ERCP 检查,并取活检行病理检查,确定恶性肿瘤的病变长度,行病变段胆管扩张后置入金属支架,引流胆汁。于支架置入7～14 d 后采用相应的自制粒子载体将^(125)I 粒子置入,行腔内持续近距离放射治疗。术后随访6～32个月,进行 B 超及内镜复查。结果 12例患者均顺利完成操作,无手术并发症。术后随访,超声及内镜结果与术前无明显变化,12例均存活,2例已存活32个月。结论内镜下肝外胆管癌及壶腹癌^(125)I 粒子腔内持续照射,是治疗晚期恶性肿瘤的安全有效的方法。

Objective To investigate the method and the value of ^125Iodine seeds used in late stage cholangioeareinoma and carcinoma of ampulla. Methods Twelve patients with eholangioeareinoma or carcinoma of ampulla were diagnosed by uhrasonography （ US ） and computerized tomography （CT） and magnetic resonance imaging（MRI） and treated by endosoeopie retrograde eholangio-panereatography. During the procedure,endoscopic biopsies for histopathologieal examination were taken, and the length of the cancer was measured, then the metal biliary stent was installed. Implanted the ^125Iodine seed into the stent by self-mode carrier 7 - 14 days after operation, so that ^125Iodine seed exerted braehytherapy. Follow-up was regularly taken at 6 -32 months by US and endoscopy. Results Twelve patients have been completed the operation, any postoperative complications never happened. In the follow-up program, any changes in US and endoscopy were not shown in all patients. Two cases have survived for 32 months. Conclusion ^125 Iodine endospoie seeds braeh therapy is a safe and effective treatment in late stage eholangioeareinoma and carcinoma of ampulla.