三维组织间后装插植治疗局部晚期胰腺癌的基础研究

A basic study of three-dimensional interstitial brachytherapy implantation in treatment of locally advanced pancreatic cancer

目的:探究胆(胃)肠吻合术中植入施源管术后三维后装治疗局部晚期胰腺癌的可行性及安全性。方法:选取3只40 kg正常家猪作为实验对象,术前运用Mimics Innovation Suite医疗软件重建系统对实验动物进行胰腺与周围血管、组织、器官的三维重建,模拟施源器植入的过程,术中按计划植入施源管,术后给予实验动物胰腺不同的放射剂量,术前术后常规进行血液学检查,术后60 d处死实验动物,观察腹腔有无炎症,渗出,穿孔,粘连等表现。结果:3只实验动物植入施源管后成功按计划进行放疗。实验动物并没有出现严重的放疗毒副反应,胰腺周围相邻的腹腔脏器并没有出现渗出、出血、坏死,进行放疗后血液学检查并未发现任何异常。结论:三维后装治疗局部晚期胰腺癌是可行的,安全的。

Objective: To investigate the feasibility and safety of three-dimensional brachytherapy after implan-tation of source tube during cholangioenterostomy or gastroenterostomy in the treatment of locally advanced pancreat-ic cancer. Methods: A total of three normal pigs with a body weight of 40 kg were selected for the experiment. Mim-ics Innovation Suite was used before surgery to perform three-dimensional reconstruction of the pancreas and thesurrounding blood vessels, tissues, and organs and simulate the process of source applicator implantation. Thesource applicator was implanted according to the plan during surgery, and the experimental animals were treatedwith irradiation of the pancreas at different doses after surgery. Routine hematological examination was performed af-ter surgery. The experimental animals were sacrificed at 60 days after surgery to observe the presence or absence ofabdominal inflammation, exudation, perforation, and adhesion. Results: Radiotherapy was performed for all threepigs after successful implantation of the source applicator. No pigs showed serious adverse reactions to radiotherapy,and there were no exudation, bleeding, or necrosis in the adjacent abdominal visceral organs, and the hematologicalexamination performed after radiotherapy showed no abnormality. Conclusion: Three-dimensional brachytherapy isfeasible and safe in the treatment of locally advanced pancreatic cancer.