立体定位放射性125 Ⅰ粒子永久植入治疗晚期胰腺癌体会(附17例报告)

目的探讨中晚期胰腺癌姑息性捷径手术后体内放射治疗延长病人生存期、改善生活质量的有效性及可行性.方法对我院2000年5月～2001年10月间收治的17例晚期胰腺癌病人行捷径手术后永久植入放射量为0.6～0.8毫居里(mCi)的125I粒子,术后随诊观察生存期、疼痛缓解及并发症发生率.结果所有病例得到随诊,病人术后中位生存期平均191d.其中6例术后CT及MRI随诊肿瘤明显缩小;3例病人术后生存超过1年,占17.6%;1例病人经125I治疗后1个月成功行胰十二指肠切除术.所有病人无明显骨髓抑制.结论经125I治疗并辅助化疗,本组病人中位生存期明显延长.证明立体定位体内放射粒子植入术治疗胰腺癌有效可行,其优越性为靶器官准确且正常组织损伤小、方法简便经济.

Permanent interstitial implantation of radiant 125iodine for advanced pancreatic cancer

Objective To study the effect and possibility of the permanent interstitial implantation of radiant 125iodine for advanced1 pancreatic cancer.Methods Seventy patients with advanced pancreatic cancer were treated with radiant 125 I intra-tumor implantation after obstructive jaundice shunt operation. Survival time and the pain relief rate were observed. Postoperative follow-up was carried out on all patients. The mid-survive time was 191 days and 3 ( 17.6 % ) patients survived over one year. One patient underwent pancreaticoduodenectomy one month after implantation of 125 I. No bone marrow depression occurred. Three patients with pancreatic fistula were treated well by drainage.Conclusion 125 I implantation radiotherapy combined with adjuvant chemotherapy for advanced pancreatic cancer was feasible and yielded a longer survival time.