经导管~(192)Ir近距离放射治疗局部晚期肝门部胆管癌

目的：观察局部晚期肝门部胆管癌姑息性引流术后１９２Ｉｒ腔内放疗的疗效。方法：先行手术探查尽可能刮除肿瘤并放置Ｕ型管引流，术后再经导管腔内放疗。参考点距离放射源中心轴１０ｍｍ，总量２４～３０Ｇｙ／３次。３例配合肝动脉区域性灌注化疗，１例配合外照射ＤＴ４５Ｇｙ／４．５周。结果：生存期６～２６个月，中位生存期１１．５月。１５例死亡，１例目前存活８个月。全组１年生存率３７．５％，２年生存率６．０％，结论：局部晚期肝门部胆管癌姑息性引流术后腔内放疗可提高生存期及生活质量

Intraluminal 192 Ir Brachytherapy for Local Advanced Hilar Bile Duct Carcinoma

To assess the effect of intraluminal 192 Ir brachytherapy for local advanced hilar bile duct cancer after palliative biliary drainage,16 patients with advanced hilar cholangiocarcinoma underwent laparotomy and had their tumor resected as much as possible. After establishment of bile drainage using a U tube intraluminal 192 Ir was placed. The reference doses calculated at 10mm from the source varied from 24 to 30 Gy in 3 fractions. Three patients were treated with combination of hepatic artery perfusion chemotherapy.One patient recieved external radiation (45Gy over 4.5 weeks). The survival time of these patients were 6 26 months with a median of 11.5 months. Fifteen patients died. One patient was still alive for 8 months. The 1 , 2 year survival rates for the whole group were 37.5% and 6% respectively. It is concluded that palliative bile drainage followed by intraluminal brachytherapy could improve the survival quality of life in patients with local advanced hilar bile duct carcinoma.