经皮胆管穿刺并调强适形放疗治疗晚期肿瘤阻塞性黄疸

Treatment of obstructive jaundice by percutaneous biliary puncture combined with intensity modulated radiation therapy in the advanced cancer

目的评价经皮胆管穿刺并调强适形放疗治疗晚期肿瘤阻塞性黄疸的疗效。方法19例晚期肿瘤阻塞性黄疸患者经皮胆管穿刺体外引流并调强适形放疗。按世界卫生组织（WHO）标准评价近期疗效。结果19例患者中完全缓解（CR）2例（10．5％），部分缓解（PR）15例（78．9％），稳定（NC）1例（5.3％），进展（PD）1例（5.3％），总有效（CR＋PR）率89．4％（17／19），黄疸消退缓解率94．7％（18／19）。患者6、12、18个月生存率分别为78．9％（15／19）、47．4％（9／19）、15．8％（3／19），中位生存期10个月。结论采用经皮胆管穿刺并调强适形放疗方法治疗晚期肿瘤阻塞性黄疸患者，虽然是一个姑息治疗，但仍取得了较好的治疗效果，且不良反应小，患者可以耐受，值得进一步临床研究。

Objective To evaluate the efficacy of advanced cancer treatment of obstructive jaundice by percutaneous biliary puncture and intensity modulated radiation therapy, Methods Nineteen patients with advanced cancer of obstructive jaundice were treated by skin biliary puncture combined with intensity modulated radiation therapy. Results In 19 patients evaluated by the WHO criteria, 2 cases （10.5 %） had complete response （CR）, 15 cases （78.9 %） had partial response （PR）, while 1 case （5.3 %） had stable disease （SD） and 1 case （5.3 %） got progressive disease （PD）. Jaundice relieve rate was 94.7 % （18/19）, 6, 8, 12 months survival rates were 78.9 % （15/19）, 47.4 % （9/19）, 15.8 % （3/19）, and the median overall survival time was 10 months. Conclusion Percutaneous biliary puncture combined with intensity modulated radiation therapy is well effective for patients with advanced cancer of obstructive jaundice, related toxicities are tolerable. These results indicate that further clinical study is of great worth.