CT引导下^(125)I放射性粒子植入和单纯化疗治疗胰腺癌的疗效评价

Comparison of therapeutic effects between CT-guided ^(125)I seed implantation and chemotherapy with Gemcitabine for the treatment of unresectable pancreatic carcinoma

目的比较125I粒子和单纯吉西他滨化疗治疗中晚期胰腺癌的作用。方法将46例不能手术切除的中晚期胰腺癌患者分为2组:A组22例(125I粒子植入组)和B组24例(吉西他滨静脉化疗组)。疗效评价主要指标包括临床受益率、客观肿瘤疗效、安全性和生活质量评估。结果治疗后3个月,有效率A组为45.5%,B组为8.3%。临床受益率A组为47.1%,B组为25.0%。A组无进展生存期中位时间为4个月,B组为3个月。两组毒性反应率和并发症率无差异。结论125I粒子和吉西他滨在治疗中晚期胰腺癌方面均有一定的缓解率,但125I粒子比吉西他滨能更好的改善患者的生存质量,提高生存率。

Objective To compare the therapeutic effects of CT-guided ^125I seed implantation with simple Gemeitabine chemotherapy for the treatment of uuresectable pancreatic carcinoma. Methods Forty-six untreated patients with unresectable advanced pancreatic carcinoma were randomly divided into two groups： group A （n = 22）, treated with ^125I seed implantation and group B （n = 24）, treated with intravenous chemotherapy using Gemcitabine only. The clinical benefit response （CBR）, objective tumor response （OTR）, safety and the improvement of living quality were evaluated and analyzed. Results Three months after the treatment, the OTR rate of group A and group B was 45.5% and 8.33% respectively （P 〈 0.05）. The CBR rate of group A and group B was 47.1% and 25% respectively （P 〈 0.05）. No significant difference in PFS between group A and group B （P 〉 0.05）. And also, the incidence of hematological toxicity and complication between two groups were of no significant difference. Conclusion For the treatment of advanced unresectable pancreatic carcinoma, both simple Gemcitabine chemotherapy and ^125I seed implantation are able to obtain a moderate objective response, although ^125I seed implantation seems to be more effective than Gemcitabine in improving the living quality and survival rate.