外照后铱^(192)高剂量腔内近距离放疗晚期胆管癌

Intraluminal ^(192)ir brachytherapy for local advanced hilar duck carcinoma with external radiation

目的 观察晚期肝门部胆管癌姑息性引流术后铱1 92 腔内近距离放疗的疗效。方法 先行手术探查尽可能刮除肿瘤并放置U型管引流 ,术后再经导管腔内放疗。剂量参考点距施源器中心轴的距离 10～ 12mm ,参考点剂量为每次 6～ 8Gy ,每周一次 ,共 3次 ,配合外照射 ,外照总量为 5 0～ 60Gy/周。结果 生存期 6～ 2 6个月 ,中位生存期为 11.2个月 ,1、2、3、4年生存率分别为46.2 % (6/13 ) ,44 .4% (4 /9) ,3 3 .3 % (2 /6) ,3 3 .3 % (1/3 ) ,无严重的副反应。

Objective To assess the effect of intraluminal 192 ir brachytherapy for local advanced hilar bile duck cancer after palliative biliary drainage.Methods The patients with advanced hilar cholangiocarcinoma underwent laparotomy and had their tumor resected as much as possible.After establishment of bile drainage using a U tube intraluminal 192 Ir was placed.The reference dose was calculated at 12mm from the source varied from 24 to 32 Gy in 3 infractions.Patients received external radiation from 50 to 60 Gy over 5 weeks.Results the survival time of this patient was 6～26 months with a median of 11.2 months.The 1,2,3 and 4 year survival rates for the whole group were 46.2%(6/13),44.4%(4/9),33.3%(2/6),and 33.3%(1/3).There wasn't any severe side effects.Conclusion The palliative bile drainage followed by intraluminal brachytherapy could improve the survival quality of life in patients with local advanced hilar bile duct catcinoma.