内镜下胆管支架植入术结合三维适形放疗治疗晚期壶腹部恶性肿瘤

Endoscopic Retrograde Biliary Stenting Combined with 3-dimensional Conformal Radiotherapy in Treatment of Advanced Malignant Tumour of Ampula

目的评价内镜下胆管支架植入术结合三维适形放疗(简称联合治疗)治疗晚期壶腹部恶性肿瘤的疗效。方法共165例无法手术根治的晚期壶腹部肿瘤患者纳入研究。分为联合治疗组(73例)、支架植入组(34例)及放疗组(58例)。所有病人治疗后均行密切随访。结果联合治疗组的生存期为15.6±8.2个月,显著高于支架组的10.1±5.4月及放疗组的8.5±4.3月(P均<0.01)。治疗过程未出现严重的并发症。结论内镜下胆管支架植入术结合三维适形放疗安全、有效,可显著延长晚期壶腹部恶性肿瘤患者的生存期。

Objective To evaluate the effect of endoscopic retrograde biliary stenting（ERBS） combined with 3-dimensional conformal radiotherapy （ combined therapy） in treatment of advanced malignant tumour of ampula. Methods From 2002 to 2006,165 cases of unradical operation patients with advanced malignant tumour of ampula were enrolled in the study and were divided into three groups, combined group（ 73 cases）, ERBS group （34 cases） and radiotherapy group （58 cases ）. Close follow-up was carried out in every patient after treatment. Results The survival period of combined group patients was 15.6 ± 8. 2 months, which was longer than that in ERBS group（ 10. 1±5.4 months） and that in radionthrapy group（8.5 ± 4. 3 months） significantly （ all P 〈 0. 01 ）. There were no serious complications in the treatment. Conclusion Endoscopic retrograde biliary stenting combined with 3-dimentsional conformal radiotherapy could obviously prolong the survival periods of patients with advanced malignant tumour of ampula, which is a safe and effective therapy.