CT引导下^(125)I粒子植入联合药物化疗治疗晚期局部胰腺癌临床评价

Clinical Evaluation of CT Guided ^(125)I Particle Implantation Combined with Topical Drugs Chemotherapy in Treating Advanced Pancreatic Cancer

目的观察CT引导下^(125)I粒子植入联合药物化学治疗(简称化疗)治疗晚期局部胰腺癌的疗效和安全性。方法选择医院2015年晚期局部胰腺癌无法手术切除的患者82例,采用随机数字表法分为两组,各41例。对照组患者行吉西他滨全身化疗;观察组患者在CT引导下行^(125)I粒子植入联合吉西他滨全身化疗治疗。结果观察组总有效率为90.24%,明显优于对照组的26.82%(P<0.05);观察组患者疼痛阳性改善率为56.10%,镇痛药物用量阳性改善率为31.71%,体力阳性改善率为14.63%,分别明显高于对照组的24.39%,4.88%,0(P<0.05);观察组6个月、12个月无进展生存率分别为56.10%和26.83%,明显高于对照组的17.07%和7.32%(P<0.05)。治疗后,观察组躯体、情绪、角色和社会功能4个功能因子评分较本组治疗前及对照组治疗后明显提高(P<0.05);疼痛、疲倦和恶心呕吐3个症状因子评分较本组治疗前及对照组治疗后明显降低(P<0.05)。观察组^(125)I粒子植入患者发生1例上消化道出血,经保守治疗出血停止,1例粒子肝脏移位,随访期间肝功能正常,未出现胰瘘、消化道穿孔、急性胰腺炎等并发症。结论 CT引导下^(125)I粒子植入联合药物化疗治疗局部晚期胰腺癌具有近期疗效好、患者受益多、并发症少的优点,可明显改善患者的生活质量。

Objective To observe efficacy and safety of the CT guided ^（125）I particle implantation combined with topical drugs chemotherapy in treating advanced pancreatic cancer. Methods Totally 82 patients with unresectable locally advanced pancreatic cancer in 2015 were selected and randomly divided into two groups according to the digital table,41 cases in each group. The control group received gemcitabine chemotherapy,while the observation group was given CT guided ^（125）I particle implantation combined with gemcitabine chemotherapy.Results The total effective rate of the observation group was 90. 24%,which was obviously better than 26. 82% of the control group（ P〈0. 05）. In the observation group,the positive improvement rate of pain was 56. 10%,the positive improvement rate of the dosage of analgesic drugs was 31. 71%,and the positive improvement rate of physical was 14. 63%,which was significantly higher than 24. 39%,4. 88%,0 of the control group（ P〈0. 05）. The rates of progression free survival in the observation group was 56. 10% and 26. 83%at 6,12 months,respectively,which were significantly higher than 17. 07% and 7. 32% of the control group（ P〈0. 05）. After treatment,the scores of 4 functional factors of body,emotion,role and social function in the observation group were significantly higher than those before treatment and those in the control group after treatment（ P〈0. 05）,but the scores of 3 symptoms factors of pain,fatigue and nausea and vomiting were significantly lower than those before treatment and those in the control group after treatment（ P〈0. 05）.In the observation group,1 cases of upper gastrointestinal hemorrhage occurred after ^（125）I particle implantation,and the bleeding stopped after conservative treatment,the particle displacement of the liver was observed in 1 patients with normal liver function during the follow-up period,and no complications such as pancreatic fistula,perforation of digestive tract,and acute pancreatitis were found.Conclusion CT guided ^（125）I particles implantation combined with chemotherapy drugs in the treatment of locally advanced pancreatic cancer has the advantages of better short-term curative effect,more benefits and less complications,and can obviously improve the patient＇s quality of life.