125I放射性粒子植入治疗无法手术切除的胰腺癌疗效分析

目的：探讨^125I放射粒子植入术治疗手术无法切除的胰腺癌的治疗疗效。方法：选择胰腺癌患者50例，内放射治疗组30例，肿瘤内部^125I放射粒子植入，有梗阻症状者，加行胆-肠吻合术和胃-空肠吻合术；对照组20例，均行单纯剖腹探查或胆-肠吻合术和（或）胃-空肠吻合术。观察肝肾功能和总胆红素变化、肿瘤大小变化、并发症发生情况、腹痛和背痛变化等。结果：两组患者总胆红素术后4周时均接近正常，肝功能明显改善，手术前后比较差异均有统计学意义；粒子植入组患者手术前后腹痛和腰痛明显改善。有效率100％（30／30），完全缓解率97％；粒子植入组肿瘤直径有缩小趋势，对照组无明显变化；两组患者均无吻合口瘘、胆瘘、胰瘘、腹腔出血和腹腔感染。结论：^125I粒子植入对不可切除的胰腺癌具有确定疗效，不仅可以明显延长患者生存期，提高生活质量，而且对胰腺癌引起的疼痛有明显的缓解效果。

Radiation effect on unresectable pancreatic carcinoma through 125I seeds implantation

OBJECTIVE:To investigate the therapeutic effect of 125I particles implantation in the treatment of unresectable pancreatic carcinoma. METHODS: Fifty cases of pancreatic carcinoma were chosen in the trial, 30 of them were treated by 125I seeds implantation accompanied with or without choledoenteroanastomosis and (or) gastrojejunostomy, and 20 cases treated with choas the choledoenteroanastomosis and (or) gastrojejunostomy. The peri-operative hepatic function, serum bilirubin, the size of the tumor, complications and the intensity of pain were observered. RESULTS: The total bilirubin decreased to normal level 4 weeks after the operation, while the liver function recovered in the cases of both the groups. Nearly all the 30 of radiotherapy cases (100%) had a perfect remission of the abdominal and back painfulness, and the CR rate was 97%. No obvious complications occurred, and tumor seemed to be smaller then. CONCLUSIONS: 125I seeds implantation has an obvious therapeutic effect to those cases of unresectable pancreatic carcinoma. It can prolong the survival period, improve the quality of life, and relieve pain obviously.