动脉灌注吉西他滨联合125I粒子胰腺内植入治疗进展期胰腺癌

目的:探讨动脉灌注吉西他滨联合125I粒子植入治疗进展期胰腺癌的临床价值。方法:43例进展期胰腺癌(APC)患者随机分成125I粒子植入 吉西他滨(GEM)治疗组(A组,n=18)和单纯吉西他滨化疗组(B组,n=25)。采用改良Dimension-averaging法计算相关放疗剂量。A组8例放置胆道支架解除黄疸,2例放置十二指肠支架解除十二指肠梗阻;B组15例行胆肠和/或胃肠吻合术,5例行ERCP解除黄疸。结果:CR PR率A组为61.1%,B组为32.0%(P<0.05)。临床受益反应率A组为72.2%,B组为40.0%(P<0.05)。3、6、12、18个月生存率A组为100%、94.4%、72.2%、61.1%,B组为100%、76.0%、32.0%、12.0%(P<0.05)。结论:125I GEM能缓解疼痛,改善APC患者的生存质量,提高生存率。

125I implantation combined with Gemcitabine in the treatment of advanced pancreatic cancer

Objective:To study the role of 125I implantation plus gemcitabine in treatment of advanced pancreatic cancer(APC).Methods: Fortythree untreated patients with APC were randomly divided into two groups: 125I plus gemcitabine(group A,n=18)and Gemcitabine(group B,n=25).The total activity and number of 125I seeds used were as recommended by the improving dimension-averaging.In group A,8 patients were treated with stents to release jaundice and 2 patients with duodenal stents placement to release the duodenal obstruction.In group B,15 patients underwent laparotomy and 5 underwent endoscopic retrpgrade cholangio-pancreatography(ERCP).Results: Overall response rate(CR PR)in group A and in group B was 61.1% and 32.0% respectively(P<0.05).Clinical benefit response was experienced by 72.2% of group A compared with 40.0% of group B(P<0.05). The survival rates of 3,6,12 and 18 months were 100%,94.4%,72.2% and 61.1% for group A and 100%,76.0%,32.0% and 12.0%for group B(P<0.05).Conclusion: 125I plus GEM is effective in easing pain,improving the health-related quality of life,and prolonging the life of patients.