放射性粒子植入治疗中晚期胰腺癌临床疗效观察

目的探讨^125I放射粒子植入治疗无法手术切除中晚期胰腺癌的疗效。方法2003年1月-2007年12月共收治无法手术切除局部进展期胰腺癌（locally advanced pancreatic cancer，LAPC）患者46例，采用前瞻随机对照法，随机分为两组，粒子植入组26例，肿瘤内植入^125I放射粒子；对照组20例，单纯行剖腹探查术。两组患者有梗阻症状者加行胆肠吻合术或胆道外引流术和（或）胃空肠吻合术。观察患者肝功能、胆红素、肿瘤大小、腹痛腰痛变化，以及并发症发生和生存期情况。结果两组患者肝功能胆红素均明显改善；粒子植入组肿瘤直径有缩小趋势，腰痛腹痛明显改善，生存期明显延长，对照组肿瘤直径无明显变化或增大，疼痛无改善；两组患者均无明显并发症。结论^125I粒子植入治疗局部进展期胰腺癌安全有效。不仅可以提高患者生活质量，而且可以明显延长患者生存期。

Effect of Radioactive Seed Implantation on Advanced Pancreatic Carcinoma

Objective To study the therapeutic effect of ^125I radioactive seed implantation on unresectable advanced pancreatic carcinoma. Methods 46 patients with locally advanced pancreatic cancer（ LAPC ） were divided into two groups randomly. 26 cases were treated by ^125I seeds implantation, and the other 20 cases were treated with exploratory laparotomy only. Cholodochojejunostomy or biliary extra-drainage and/or gastrojejunostomy were performed in patients with obstruction in the two groups. The liver function, serum bilirubin, size of tumor, intensity of pain, complications and the survival period were observed. Results The liver function and bilirubin were improved significantly in both groups. The size of tumor was smaller in ^125I impjantation group. The group treated by ^125I implantation had a perfect remission of the bellyacke and backache, and prolong the survival period. No obvi- ous complications occurred in 2 groups. Conclusion ^125I seeds implantation is safe and effective for unresectable pancreatic carcinoma. Not only can it improve the quality of life, but also prolong the survival period.