CT引导下125I粒子植入对缓解胰腺癌疼痛的疗效观察

目的:观察胰腺癌患者行125I粒子植入术后的癌痛缓解情况，评价粒子植入治疗的有效性及安全性。方法:28例晚期不可手术切除胰腺癌伴癌痛患者，术前应用治疗计划系统（ＴＰＳ）计算布源，在CT引导下将125I粒子植入胰腺病灶。随访观察患者疼痛缓解率，术前与术后疼痛视觉模拟评分（VAS）变化情况，阿片类止痛药使用情况以及生活质量评分情况。结果: 125I粒子植入术后1周、1月及3月，患者疼痛缓解有效率分别为82.1%（23/28）、67.9%（19/28）、57.1%（16/28）。VAS疼痛评分分别为（2.3±1.2）、（2.9±1.5）、（4.1±1.4）分，明显低于术前基线水平[（7.2±1.1）分]。阿片类止痛药使用量明显降低（P＜0.01），总体生活质量较前明显改善（P＜0.01）。近期不良反应轻微，无严重并发症。结论:CT引导下125I粒子植入可以有效缓解胰腺癌患者疼痛状况，明显改善患者总体生活质量。

CT-guided iodine-125 seeds implantation therapy for pancreatic cancer patients with pain

Objective: To evaluate the safety and efficacy of CT-guided radioactive seeds 125I implantation in relieving the pain of advanced pancreatic cancer patients. Methods: Twenty-eight unresectable pancreatic cancer patients with pain were studied. Treatment plan system(TPS) was used to determine the number and distribution of 125I seeds. 125Iseeds were implanted into the lesions under CT-guided. The assessment included the visual analogue scale（VAS）, quality of life, and 24 h consumption of opioids. Results: The effective rates of pain reliefinpatients were 82.1%（23/28）, 67.9%（19/28）, 57.1%（16/28）at 1 week, 1 month and 3 months post-procedure. VAS scores decreased from 7.2±1.1 to 2.3±1.2, 2.9±1.5 and 4.1±1.4 at 1 week, 1 month and 3months post-procedure, respectively. With the quality of life significantly improved (P＜0.01), 24h consumption of opioids were decreased significantly compared with pre-procedure(P＜0.01). No severe complications caused by technique were detected. Conclusion:CT-guided radioactive 125I seeds implantation is safe and effective in relieving the pain and improving the quality of life of pancreatic cancer patients.