姑息性胃大部切除加^125I粒子术中植入治疗胃癌浸润胰腺的观察

Palliative gastrectomy plus ^125I intra-operative implantation for treatment of gastric carcinoma infiltrating pancreas

目的探讨姑息性胃大部切除加术中植入^125I放射性粒子治疗胃癌浸润胰腺患者的可行性和安全性。方法对术中发现胃癌向胰腺浸润，并难以彻底切除者，在姑息性切除胃癌的同时，在胰腺残留癌组织内植入^125I放射性粒子。结果自2004年12月至2009年6月用该方法治疗晚期胃癌15例，男9例，女6例；年龄41～78岁（中位年龄64岁）；其中胃癌向胰腺头部浸润5例，向胰腺颈、体部浸润10例。术后发生胰瘘1例，继发性出血1例，经随访，CR5例（33．3％），PR9例（60％），NC1例（6．7％），无PD病例。结论对晚期胃癌浸润胰腺患者采用姑息性胃大部切除加术中植入^125I粒了的方法是安全可行的，不会增加术后并发症的发生率，具有较好的临床应用价值。

Objective To observe the feasibility of ^125Iintra-operative implantation plus palliative resection of gastric carcinoma for treatment of advanced gastric cancer infiltrating pancreas. Methods^125Iwas implanted intraoperatively into the residual pancreatic cancer tissues after gastric carcinoma was palliatively removed. Results From Feb. 2005 to Jun. 2009, 15 cases （9 male, 6 female） advanced gastric cancer patients were treated with ^125I intra-operative implantation. The patients＇ ages ranged from 41 to 78 years, with the median age of 64 years old. There were 10 cases of gastric cancer infiltrating the neck or body of pancreas and 5 cases infiltrating pancreatic bead. No severe post-operative complications were recorded. The follow-up showed that there were5 cases of CR （33.3%）, 9 cases of PR （60%）, 1 case of NC （6.7%） and no PD patients were found. Conclusion ^125I intra-operative implantation plus palliative gastric resection is feasible and effective for patients of advanced gastric cancer infiltrating the pancreas.