多方法联合手术治疗不能切除的胰腺癌

MULTI-METHODS COMBINED OPERATION FOR UNRESECTABLE PANCREATIC CANCER

目的 探索多方法联合手术对不能手术切除的胰腺癌的治疗作用。方法 2 6例胰腺癌患者 ,胰头癌 17例 ,先行减黄手术 ,然后向肿瘤内注射无水酒精 ;肿瘤内置入后装机放疗管 ;胃十二肠动脉置入多功能药物化疗泵导管 ;肿瘤周围及基底部注入自配亚甲兰合剂。胰体癌 9例 ,除经脾动脉置入多功能药物化疗泵导管外 ,其余方法同胰头癌。术后 2周施行后装机内照射及经多功能药埋藏泵注入 5 - Fu、丝裂霉素。结果 全部病例无手术死亡 ,术后 2 d10 0 % (16 / 16 )患者疼痛减轻 ,疼痛完全消失 76 .8% (12 /16 ) ,维持时间最长 2 0个月。 2个月复查 ,B超、CT示肿瘤缩小率 10 0 %。半年存活率 10 0 % (2 6 / 2 6 ) ,1年存活率 80 .7% (2 1/ 2 6 ) ,中位生存期 13.6个月。结论 多方法联合手术治疗不能切除的胰腺癌有明显的治疗效果 ,特别对疼痛治疗有良好作用 ,明显提高了患者的生存质量。

Objective To expore the effect of multi-methods combined operation for the unresectable pancreatc cancer.Methods 26 patients with pancreatic cancer were studied.17 cases with unresectable cancer in the head of pancreas were given operation for releasing jundice primarily and a percutaneous ethanos injection was followed then afterloading irradiation tube was put in the tumor Multi-prupose chemotherapic pumps were put viagastroduodenalis artery.Personal-made methyleni coerulei mixture was injected around the tumor and into its base.9 cases with the nuresectable cancer in the body of pancreas were given all of the former methods beside Multi-purpose chemotherapic pumps via lienalis artery.Intralavilary afterloading irradiation was performed and 5-Fu and MMC were injected via chemotheropic pumps two weeks after operation.Results No patients died after operatin.Two days after operation the pain was relieved(100%) in 16 patients,pain relieved thoroghly (76.8%)in 12 cases.The longest time of painless maintained 20 months.All patients were inspected by ultrosound and CT repeatedly 2 months later.The rate of restriction of tumor was 100%.1/2-Year survival rate was 100%.1-Year survival rate was 80.7%(21/26).The median survival time was 13.6 months.Conclusion The effect of Multi-methods combined operation for unresectable pancreatic cancer was remarkable,especialy for relieving pain and improving the puality of the patients lives.