^125I放射性粒子治疗高位胆管癌的临床研究

目的观察^125I放射性粒子对高位胆管癌的临床治疗效果。方法对78例高位胆管癌随机分成三组,A组27例（PTCD）、B组39例（^125I粒子）及C组12例（PTCD＋^125I粒子）,通过观察术前术后总胆红素的改变、肿瘤大小的变化及患者的生存率,分析^125I放射性粒子永久性植入治疗胆管癌的疗效。结果术后半月A,B,C三组总胆红素下降率分别为81.5%（22/27）,66.7%（26/39）,83.3%（10/12）,A,B两组及B,C两组均有显著性差异（P〈0.05）;术后一年三组（CR＋PR）分别为29.6%（8/27）,74.4%（29/39）,75.0%（9/12）,A,B两组及A,C两组均有显著性差异（P〈0.05）;术后6个月和12个月生存率B组为89.7%,82.1%,C组为91.7%,83.3%,明显高于A组的59.3%,33.3%（P〈0.05）。结论对高位胆管癌,125I放射性粒子有治疗作用,PTCD术为姑息性治疗,125I放射性粒子联合PTCD术可取得更佳效果。

Clinical Study of ~(125)I Rradioactive Particles Implanted to Treat Superior position Cholangiocarcinoma

Objective To observe the effect of ^125I radioactive particles implanted to treat superior position cholangiocarcinoma. Method 78 patients with superior position cholangiocarcinoma were collected and randomized into three group￡°groupA- PTCD 27 patients, groupB-^125I radioactive particles 39 patients and groupC- PTCD＋^125I radioactive particles 12 patients. TBIL, the tumor volume and survival rate of 78 cases were analyzed respectively to invest the efficacy. Result, TBIL decreased 81.5%, 66.7% and 83.3% respectively in A, B, C group in 2 weeks, and there were difference between groupA （81.5%） and groupB （66. 7%） or groupB and groupC（83.3%） were statistical significance （P〈0.05）; （CR＋PR） of groupA was 29.6%（8/27） at 1 year, and the difference between groupA and groupB（74.4%） or groupA and groupC（75.0%） were statistical significance （P〈0.05）; Survival rate of 6 and 12 months in group B（89.7%, 82.1%） and groupC （91.7%,83.3%） were higher than that in groupA（59.3%, 33.3%）（P〈0.05）. Conclusion Implanted ^125I radioactive particles into superior position cholangiocarcinoma is a safe and effective method. PTCD is a symptomatic treatment, Implanted ^125I radioactive particles into tumor combined with PTCD to treat superior position cholangiocarcinoma can get the better effect.