CT引导下125I粒子植入联合替吉奥治疗中晚期胰腺癌临床应用.docVIP

CT引导下125I粒子植入联合替吉奥治疗中晚期胰腺癌临床应用 　　[摘要] 目的 探讨125I粒子植入联合替吉奥治疗中晚期胰腺癌的临床疗效。 方法 回顾性分析2010年10月～2012年10月15例中晚期胰腺癌患者，所有患者行CT引导下植入125I放射性粒子治疗，术后行替吉奥方案化疗。观察患者肿瘤治疗效果、生存质量、疼痛缓解情况及生存率的改善情况。 结果 15例患者总植入放射性粒子374粒，平均24.93粒（16～43粒），平均剂量为（88.71±27.39）Gy，表面活度0.6 mCi。2个月后CT复查，达到完全缓解1例，部分缓解6例，疾病稳定4例，进展恶化4例。肿瘤治疗总有效率为46.67%。平均术后3-4天疼痛开始缓解，有效率为80%，治疗后疼痛较治疗前明显缓解。所有病例中位生存时间为11个月（95%CI：5.74-16.26）。6个月累计生存率为80.0%，1年累计生存率为40.0%，2年生存率为13.3%。随访中1例出现严重消化道出血，余患者无胰腺炎、胃肠道出血、放射性肠炎等严重并发症发生。 结论 125I粒子植入联合替吉奥对于中晚期胰腺癌近期治疗效果较好，其止痛效果明确，是一种安全微创治疗中晚期胰腺癌的方法。 　　[关键词] 胰腺癌；125I粒子；近距离放射治疗；替吉奥 　　[中图分类号] R735.9 [文献标识码] B [文章编号] 1673-9701（2015）35-0066-04 　　[Abstract] Objective To study the clinical curative effect of CT-guided radioactive 125I implanted combined with TS-1 for the treatment of middle-late pancreatic cancer. Methods A retrospective analysis was conducted on the results of 15 patients with advanced pancreatic carcinoma from October 2010 to October 2012，CT-guided 125I seed interstitial implantation was carried out，then all patients were received TS-1 treatment. The cancer treatment effect，quality of life，pain relief and survival rate improvement were evaluated. Results 15 patients were implanted 374 particles， an average of 24.93（16-43）. The average dose was （88.71±27.39）Gy， surface activity 0.6 mCi. Follow-up CT as a result two months after implantation，complete reminssion（CR） was obtained in 1 case，partial remission（PR） was obtained in 6 cases，no change（NC） was obtained in 4 cases， progressive deterioration（PD） was obtained in 4 cases. The overall effective rate（CR+PR） was 46.67%. A median survival time of patients was 11 months. 6 months cumulative survival rate is 80.0%， 12 months cumulative survival rate is 40.0%，24 months cumulative survival rate is 13.3%. 1 case experienced serious gastrointestinal bleeding，the other of patierts have no serious complications（such as pancreatitis，intestinal hemorrhage，radiation colitis，etc） occur during the operation of all the patients. Conclusion CT-guided ra