125Ⅰ种子植入内照射联合化疗治疗胰腺癌临床疗效的初步评价

目的　初步评价12 5Ⅰ种子植入内照射联合化疗治疗进展期胰腺癌的临床疗效。方法36例局部进展期胰腺癌患者随机分为两组 :放化疗组 18例 ,给予12 5Ⅰ种子植入内照射联合吉西他滨和 5 Fu化疗 ;对照组 18例 ,给予瘤体无水酒精注射。结果　放化疗组有效率达 38.9% ,疼痛缓解达77.8% ;对照组分别为 0和 2 2 .2 % ,两组比较差异有显著性 (P <0 .0 5 )。放化疗组虽有一定毒副反应 ,但患者耐受较好。放化疗组术后 6个月、12个月生存率分别为 71.4 %和 2 1.4 % ,中位生存时间为10 .6个月 ;对照组 6个月、12个月生存率分别为 38.5 %和 7.7% ,中位生存时间为 5 .2个月 ,两组比较差异有显著性 (P <0 .0 5 )。结论　12 5Ⅰ种子植入内照射联合吉西他滨和 5 Fu化疗治疗局部进展期胰腺癌 ,能控制肿瘤生长 ,缓解疼痛 ,改善患者的生活质量 ,是一种安全有效的肿瘤综合治疗手段。

Intraoperative 125I brachytherapy combined with chemotherapy for pancreatic cancer

OBJECTIVE: To evaluate the efficacy, toxicity and survival of intraoperative 125I brachytherapy combined with chemotherapy for advanced pancreatic cancer. METHODS: Thirty-six patients with advanced pancreatic cancer were randomized to two groups: brachy-chemotherapy group (n = 18) and control group (n = 18). For the combined group, intraoperative 125I implantation and gemcitabine, 5-Fu were given. For the control group, intratumoral injection of absolute alcohol was done. RESULTS: The CR + PR rate of brachy-chemotherapy group was 38.9% with pain relief in 77.8%, while that of control group was 0 with pain relief in 22.2% (P < 0.05). Although there were some toxicity in brachy-chemotherapy group, treatment was well tolerated. The 6-, 12-month survival rates of brachy-chemotherapy group were 71.4% and 21.4% and those of control group were 38.5% and 7.7%, respectively. The median survival time was 10.6 months and 5.2 months for the two groups, between which the difference was significant (P < 0.05). CONCLUSION: Interoperative 125I brachytherapy combined with chemotherapy for advanced pancreatic cancer can control tumor, relieve pain and improve quality of life. It is safe and effective.