术中125^Ⅰ放射性粒子植入治疗不能切除晚期胰腺癌的并发症和预后分析

目的探讨125^Ⅰ放射性粒子植入治疗不能切除的晚期胰腺癌的疗效、并发症及预后因素。方法分析我科从2010年8月到2013年5月期间7例术中行125^Ⅰ放射性粒子植入术的晚期胰腺癌患者的临床资料并复习相关文献。结果经过治疗，7例患者完全缓解3例，部分缓解2例，疾病稳定1例，疾病进展1例；6例伴有上腹痛患者中有4例疼痛完全缓解，1例疼痛部分缓解，1例轻度缓解。7例均有粒子移位，1例术后出现上消化道出血，经保守治疗治愈；没有胰痿、胰腺炎等并发症发生。5例患者肿瘤指标较术前都有不同程度的下降。结论125^Ⅰ粒子植入术能改善晚期胰腺癌患者疼痛症状，延长其生存时间，并发症发生率低；预后与年龄、手术方式、术后胰瘘等多因素有关，并且CA19-9的变化能在一定程度上反映预后。

Complications and prognosis of intraoperative iodine-125 seed implantation therapy in patients with unresectable advanced pancreatic cancer

Objective To investigate the complications, prognosis and efficacy of radioactive iodine-125 seed implantation in the treatment of unresectable advanced pancreatic carcinoma. Methods The clinical data of 7 patients who underwent iodine-125 seed implantation from Aug. 2010 to May 2013 were retrospectively analyzed. Results Among 7 cases, 3 cases were complete responsive, 2 cases partial responsive, one case stable disease, one case progressive disease. In 6 cases with upper abdominal pain, 4 cases acquired complete relief, one partial relief, one mild relief. All cases had the implanted seeds migration, and one case had upper gastrointestinal bleeding postoperative, complications such as pancreatic fistula and pancreatitis did not found. The levels of tumor markers in 5 patients declined in certain degrees postoperative. Conclusion 125^Ⅰ seed implantation can prolong the survival time and improve the quality of life for unresectable advanced pancreatic cancer, and which also has advantage of the low risk of complication. Prognosis relates with on age, surgical approach, pancreatic fistula and other factors, and changes of CA19-9 can partly reflect the prognosis.