放射性粒子植入治疗中晚期胰腺癌疗效分析

Radiation effect on unresectable pancreatic carcinoma by ^(125)I seeds implantation

目的:探讨125I放射粒子植入术治疗手术无法切除的胰腺癌的疗效。方法:选择胰腺癌患者50例。内放射治疗组30例,肿瘤内部125I放射粒子植入,有梗阻症状者,加行胆-肠吻合术和胃-空肠吻合术;对照组20例,均行单纯剖腹探查或胆-肠吻合术和/或胃-空肠吻合术。观察肝肾功能、总胆红素变化;肿瘤大小变化;并发症发生情况;腹痛、背痛变化等。结果:两组患者总胆红素术后4周时均接近正常,肝功能明显改善,手术前后比较均具有统计学意义;粒子植入组患者手术前后腹痛、腰痛改善明显。有效率100%(30/30),完全缓解率97%;粒子植入组肿瘤直径有缩小趋势,对照组无明显变化;两组患者均无吻合口瘘、胆瘘、胰瘘、腹腔出血和腹腔感染。结论:125I粒子植入对不可切除的胰腺癌具有确定疗效,不仅可以明显延长患者生存期,提高生活质量,且对胰腺癌引起的疼痛有明显的缓解效果。

Objective ：To investigate the therapeutic effect of ^125Ⅰ particles implantation in the treatment of unresectable pancreatic carcinoma. Methods： Fifty cases of pancreatic carcinoma were chosen in the trial, 30 were treated by ^125Ⅰ seeds implantation accompanied with or without cho is, and 20 cases as control. The peri -operative hepatic function, serum bilirubin, the size of the tumor, complications and the intensity of pain were observed. Results： The total bilirubin was decreased to normal level 4 weeks after the operation, while the liver function was recovered in both groups. Nearly all the 30 cases treated by radiotherapy had a perfect remission of the abdominal and back pain, no obvious complications occurred, and tumors were smaller. Conclusion：^125Ⅰ seeds implantation has an obvious therapeutic effect to those cases with unresectable pancreatic carcinoma. It can prolong the survival period, improve the quality of life, and can obviously release the pain of patients.