胆管腔内联合瘤体内植入~(125)I粒子治疗不可切除胰头癌

目的观察~(125)I粒子胆管腔内联合瘤体内植入治疗不可切除胰头癌(PHC)的效果。方法回顾性分析72例不可切除PTH患者的临床资料,其中37例接受胆管腔内联合瘤体内植入~(125)I粒子治疗(~(125)I组),35例接受腹腔镜姑息性手术(PS组),对比2组术后肝功能、并发症、中位生存时间及截止随访终点时生存率。结果与术前比较,2组术后1、3及6个月时血清总胆红素、丙氨酸氨基转移酶及天门冬氨酸氨基转移酶水平均降低,白蛋白水平均升高,且术后3、6个月时~(125)I组较PS组更为显著(P均0.05)。PS组术后并发症发生率为28.57%(10/35),~(125)I组为21.62%(8/37),组间差异无统计学意义(P=0.496)。PS组患者中位生存时间为9个月,~(125)I组为11个月,组间差异有统计学意义(P=0.041)。结论胆管腔内联合瘤体内植入~(125)I粒子可有效缓解PHC所致胆管梗阻症状,延长患者生存期。

125I particle bile duct intraluminal and intratumoral implantation for treatment of unresectable pancreatic head carcinoma

Objective To explore the efficacy of ¹²⁵I particle bile duct intraluminal and intratumoral implantation for treatment of unresectable pancreatic head carcinoma (PHC). Methods Clinical data of 72 patients with unresectable PHC were analyzed retrospectively. Among them 37 patients were treated with ¹²⁵I particle bile duct intraluminal and intratumoral implantation (¹²⁵I group), and 35 cases underwent laparoscopic palliative surgery (PS group). The postoperative liver function, complications, medial survival time and survival rate at the end of follow-up were compared between the two groups. Results The levels of serum total bilirubin, alanine aminotransferase and aspartate aminotransferase significantly decreased compared with those of preoperation, the level of serum albumin significantly decreased at 1, 3 and 6 months of postoperation in both groups, especially in ¹²⁵I group at 3 and 6 months of postoperation (all P<0.05). The incidence of postoperative complications was 28.57% (10/35) in PS group and 21.62% (8/37) in ¹²⁵I group, and there was no significant difference between the two groups (P=0.496). The medial survival time was 9 months in PS group and 11 months in ¹²⁵I group (P=0.041). Conclusion ¹²⁵I particle bile duct intraluminal and intratumoral implantation can effectively alleviate symptoms of bile duct obstruction and prolong survival time of PHC patients.