125I籽源与缓释化疗粒子联合植入靶向治疗进展期胰腺癌

目的:建立放、化疗粒子联合植入法综合治疗进展期胰腺癌.方法:26例进展期胰腺癌中胰头癌19例,胰体癌7例.肿瘤最大直径均大于4 cm,大于5 cm者5例.行内引流术22例.在治疗计划指导下,于术中先植入5-氟尿嘧啶(5-FU)缓释化疗粒子,再植入放射性125I粒子,肿瘤匹配周边剂量(matched peripheral dose, MPD)为60～80 Gy.平均每例使用125I粒子16粒和5-FU 1000 mg.结果:全部病例经过3～19个月随访观察,无手术并发症发生.16例瘤体缩小超过四分之一.26例患者中位生存期为12个月,最长1例随访时间为术后19个月,现仍存活.结论:放射性125I粒子和5-FU缓释化疗粒子联合应用局部植入技术是综合治疗进展期胰腺癌的有效手段之一.

Radiochemotherapy with interstitial implantation of 125I seeds and 5-FU slow-release seeds for advanced pancreatic cancer

Objective To establish the combined treatment technique with interstitial implantation of 125I seeds and 5?FU slow-release seeds for advanced pancreatic cancer. Methods 26 cases of advanced pancreatic cancer were treated with radiochemotherapy from August of 2001 to December of 2003, among which 19 cases of caput pancreatic cancer and 7 in pancreatic corpus. The sizes of tumor in 21 cases were larger than 4?cm in diameter, 5 cases larger than 5?cm. 5?FU slow-releasing seeds were first implanted, and then 125I seeds. The MPD of 125I seeds implantation were 60-80?Gy. The internal drainage was performed in 22 cases. The mean 16 granules of 125I seeds and 5?FU 1?000?mg were used in every patient. Results Fully operating procedure was accomplished for all the patients. Only 2 cases died due to bone and lung metastases in 3 and 4 months postoperatively. The reduced size of tumor was >1/4 in 16 cases. The median survival stage was 12 months. No operating complication occurred. Conclusion Radiochemotherapy with interstitial implantation of 125I seeds and 5?FU slow-releasing seeds is effective in the treatment of advanced pancreatic cancer.