B超引导下~(125)I粒子植入治疗胰腺癌的临床研究

目的探讨125I粒子永久性植入组织间治疗不能切除的胰腺癌的临床疗效。方法 62例患者经B超、CT、MRI等影像学检查及穿刺活检后临床确诊为胰腺癌,病灶直径为7.35(5.46~9.17)cm。其中腹痛较剧者51例,黄疸28例。采用计算机立体定位计划系统(treatment plan system,TPS)计算布源,术中超声实时监视,均匀布针并植入125I粒子。术后超声确认植入部位及有无漏植。结果 20例患者疼痛完全缓解,19例部分缓解,23例无效,平均术后3~8 d疼痛缓解;9例死于局部进展,5例死于远处转移,全组中位生存时间11个月。2个月后CT复查,完全缓解(CR)3例,部分缓解(PR)27例,无变化(NC)20例,进展(PD)12例。总有效率(CR+PR)48.39%。结论 B超引导下放射性粒子植入治疗胰腺癌创伤小,并发症发生率低,生活质量改善明显,近期效果好,可以较好地减轻疼痛症状,具有定位精确、实时监视的特点,是治疗中晚期胰腺癌简单、安全、有效的方法。

Ultrasound-guided 125I seed implantion in the treatment of pancreatic cancer

Objective To investigate the clinical value of Ultrasound-guided radioactive seed125 I implantation in the treatment of pancreatic cancer. Methods Sixty-two patients with pancreatic cancer,with an average of 7. 35 cm in size,underwent Ultrasound-guided radioactive seed125 I implantation. Of the62 patients,5 had severe abdominal pain and 28 had jaundice. Treatment plan system was used to design the distribution of the seed125 I needed under Ultrasound guidance. Results Complete relief（ CR） of abdominal pain was seen in 20 patients,partial relief（ PR） in 19 patients,and no change（ NC） in 23 cases. The abdominal pain was relieved 3- 8 days after the implantation. CT performed 2 months after implantation showed CR in 3 cases,PR in 27 cases,NC in 20 cases,and progression in 12 cases,with an overall effective rate of 48. 39. 9% patients died of local progression and 5 patients died of distant metastasis. The median survival time was 11 months. Conclusion Ultrasound-guided radioactive seed125 I implantation can improve quality of life in the treatment of pancreatic cancer,with the advantages of good short-term effect,minimal invasiveness,few complications,precise orientation,real-time monitoring.