影像引导下放射性粒子植入治疗不可切除胰腺癌的疗效评价

The follow-up study of image guided 125I seed permanent brachytherapy for the treatment of unresectable pancreatic cancer

目的 探讨影像引导下125I放射性粒子组织间植入治疗不可切除胰腺癌的临床价值.方法 回顾性随访评估为不可切除的25例胰腺癌患者,其中放射性粒子植入组13例,非手术治疗组12例.观察比较两组患者的临床受益、客观疗效、并发症及毒副反应、生存情况等,对该技术的可行性及安全性进行初步临床评价.结果 放射性粒子植入组与非手术治疗组相比：临床受益率分别为92％ （12/13）和42％（5/12）,差异有统计学意义（x2=7.354,P＜0.01）;评价为有效的例数分别为6例（46％）和4例（33％）,差异无统计学意义（x2=0.427,P＞0.05）;放射性粒子植入组术后均未出现严重并发症;后续化疗患者6例出现严重不良反应,其中放射性粒子植入组3例（23％,3/13）,非手术治疗组3例（25％,3/12）,差异无统计学意义（x2 =0.013,P＞0.05）;两组生存率比较x2=0.001,P =0.969,差异无统计学意义.结论 125I放射性粒子植入治疗不可切除胰腺癌,可明显缓解癌痛,改善生活质量.

Objective To explore the clinical efficacy of image-guided 125I radioactive seed interstitial implantation therapy for unresectable pancreatic cancer.Methods 25 patients with unresectable pancreatic cancer evaluated by retrospective follow-up were enrolled in this study,13 patients received radioactive seeds implantation while 12 patients were given non-surgical treatment.We observe and compare the clinical benefits,objective curative effect,complications,adverse reaction,survival between the two groups of patients.Results Compared with the non-surgical treatment group,the clinical benefit rate in the radiotherapy seed implantation group was 92％ （12/13） while that of the non-surgical group was 42％ （5/12）,the difference was of statistically significance.The numbers of cases evaluated as effective were 6 （46％） and 4 （33 ％） respectively,the difference was not statistical significant （x2 =0.427,P ＞ 0.05）;The radioactive seed implantation group had no serious postoperative complications;3 cases who received subsequent chemotherapy in radioactive seed implantation group（23％,3/13） and 3 cases in non-surgical treatment group（25％,3/12）suffered from serious adverse reactions,the difference was of no statistical significance（x2 =0.013,P ＞0.05）;Comparing the survival rate between the two groups,x2 =0.001,P =0.969,the difference was of no statistical significance.Conclusions The therapy of 125I radioactive seed implantation for unresectable pancreatic cancer significantly relieves cancer caused pain and improves quality of life.