125I放射性粒子植入治疗晚期胰腺癌26例临床分析

Clinical analysis of 125I radioactive seeds implantation treatment in 26 cases of advanced pancreatic cancer

目的 探讨125I放射性粒子植入治疗晚期胰腺癌的临床效果.方法 选择无外科根治性手术适应证的胰腺癌患者26例,开腹行125I放射性粒子植入术,胆肠Rou-en-y吻合术.术后观察：（1）术后胆红素下降情况;（2）术后1周内每日患者疼痛的缓解情况;（3）术后并发症发生情况.随访观察肿瘤变化、疼痛缓解程度以及存活期.结果 （1）术后1周内胆红素值降至术前一半的占52.3％（11/21）,以后胆红素继续缓慢下降,所有患者均在3周内降至正常;（2）术后1周94.7％的患者疼痛缓解,平均缓解时间为（5.0±1.5）d.18例（69.2％）术后出现胃肠功能紊乱,6例出现胃瘫（23％）,平均治愈时间为（16±5.1）d.胰漏3例经保守治疗痊愈,24例患者进行术后随访,平均生存期（12±5.1）个月,肿瘤较术前有缩小9例（37.5％）,肿瘤无明显增大10例（41.6％）,肿瘤明显增大5例（20.8％）.结论 125I放射性粒子植入可有效改善晚期胰腺癌症状,一定程度上抑制肿瘤,是晚期胰腺癌有效治疗方法之一.

Objective To investigate the effect of iodine-125 seed implantation in the treatment of unresectable pancreatic carcinoma.Methods A total of 26 pancreatic carcinoma patients were retrospectively analyzed.Patients undergoing palliative operation in combination with iodine-125 seed implantation.jundice recovery,objective tumor response,pain relieved,clinical benefit response,median survival time and complication were investigated.Results Half of cases with jundice has reduced and totally normal in 3 weeks.Abdominal pain was relieved in 94.7% patients,average recovery duration was （5.0 ± 1.5） d.18 cases had gastroenterol function disorder （69.2%）,gastroparesis in six cases （23%） and average recover time was （16 ± 5.1） d.24 of 26 cases were follow up study,median survival time was （12 ± 5.1） months,objective tumor response was smaller than preoperation in 9,no change in 10 and 5 cases became larger than before.Conclusions Palliative operation in combination with iodine-125 seed implantation is safe and effective in the treatment of unresectable pancreatic carcinoma.