胆道支架置入联合内外放疗治疗恶性阻塞性黄疸的临床研究

Clinical research of treatment of malignant Obstructive Jaundice by biliary stent implantation combined with inner and outer Radiotherapy

目的研究胆道支架置入结合后装腔内放疗加适形治疗恶性阻塞性黄疸的疗效。方法回顾分析83例恶性阻塞性黄疸病例的资料,其中综合组(胆道支架置入+后装腔内放疗+适形放疗)27例,内照射组(胆道支架置入+后装腔内放疗)25例,单纯组(单纯胆道支架置入)31例。结果三组病例在胆道支架置入后总胆红素在一月内明显下降,单纯组第1月和第6月总胆红素值比较显示总胆红素值升高,而同期,内照射组及综合组总胆红素值比较显示总胆红素值降低,但单纯组和内照射组治疗5月后肿瘤较治疗前增大,单纯组无CR、PR,内照射组肿瘤缓解率(CR、PR)率56.0%,综合组肿瘤缓解率(CR、PR)率77.7%,综合组0.5年,1年,2年生存率分别为27(100%),21(77.7%),15(55.5%)高于单纯组25(80.6%),14(45.1%),2(6.45%),及内照射组25(100%),18(72%),7(28%)。结论胆道支架置入后结合后装腔内放疗加适形治疗是一种安全有效的方法。

Objective To evaluate the clinical efficacy of biliary stent implantation combined with brachytherapy and conformal radiotherapy in treatment of malignant obstructive Jaundice.Methods The data of 83 cases with malignant obstructive Jaundice were reviewed and analyzed,of which 27 cases（Synthetic Group） were treated by biliary stent implantation combined with brachytherapy and conformal radiotherapy,25 cases（Internal Radiation Group） with biliary stent implantation and brachytherapy,and 31 cases（control Group） with biliary stent implantation.Results TBIL of all cases declined within a month,but TBIL of the cases of control group increased,indicated by the contrasting data of the first and the sixth months,while that of the other cases continuously declined in the same period.The tumour expanded in Contrast Group,without CR and PR,and Internal Radiation Group after five months,with the tumour contracted in Internal Radiation Group with 56.0% in laxation rate of CR and PO while that in Synthesize Group with 77.7%.Besides,the survival rate in 0.5,1,and 2 years in Synthetic Group,which were 27（100%）,21（77.7%） and 15（55.5%） respectively,were higher than those in Contrast Group,which were 25（80.6%）,14（45.1%） and 2（6.45%）,and that in Internal Radiation Group which were 25（100%）,18（72%） and 7（28%） respectively.Conclusions Biliary stent implantation combined with brachytherapy and conformal radiotherapy is a safe and effective way.