[1]胡小四,庞 青,刘会春,等.经皮胆道支架联合导管载入式125I粒子治疗局部进展期肝外胆管癌的疗效评价与预后因素分析 [J].介入放射学杂志,2019,28(04):369-375.
 HU Xiaosi,PANG Qing,LIU Huichun,et al.Percutaneous biliary metallic stent implantation combined with catheter- loaded 125I seeds in the treatment of locally advanced extrahepatic cholangiocarcinoma: evaluation of curative effect and analysis of prognostic factors[J].journal interventional radiology,2019,28(04):369-375.
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经皮胆道支架联合导管载入式125I粒子治疗局部进展期肝外胆管癌的疗效评价与预后因素分析
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
28
期数:
2019年04期
页码:
369-375
栏目:
临床研究
出版日期:
2019-04-25

文章信息/Info

Title:
Percutaneous biliary metallic stent implantation combined with catheter- loaded 125I seeds in the treatment of locally advanced extrahepatic cholangiocarcinoma: evaluation of curative effect and analysis of prognostic factors
作者:
胡小四 庞 青 刘会春 周 磊 金 浩 王 炜 陈邦邦
Author(s):
HU Xiaosi PANG Qing LIU Huichun ZHOU Lei JIN Hao WANG Wei CHEN Bangbang.
Department of Hepatobiliary Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province 233004, China
关键词:
【关键词】 近距离放射 肝外胆管癌 金属胆道支架 碘-125粒子
文献标志码:
A
摘要:
【摘要】 目的 探索经皮金属胆道支架植入联合导管载入式125I粒子(SEMS- CL- 125I)的腔内综合治疗在局部进展期肝外胆管癌(LA- EHCC)的效果及预后因素分析。方法 回顾性分析2015年1月至2017年6月行SEMS- CL- 125I治疗的78例LA- EHCC患者的临床资料,统计其血清生化指标变化情况。Cox回归模型分析影响总生存时间(OS)的相关因素。结果 78例中,肝门部胆管癌(pCCA)37例,远端胆管癌(dCCA)41例。与胆道引流前血清总胆红素(TBIL)248.8(155.8,334.0) μmol/L相比,术后1、3、6个月TBIL分别下降至34.5(18.6,47.5) μmol/L、14.2(9.3,17.0) μmol/L、13.3(10.7,19.8) μmol/L,差异均有统计学意义(P<0.05)。平均生存时间(14.4±5.8)个月,1、2年生存率分别为65.0%、20.7%。dCCA与pCCA组患者间OS差异无统计学意义(P=0.161);术后联合辅助化疗的患者OS显著改善,差异有统计学意义(P<0.05)。Cox回归分析提示TBIL≥222.4 μmol/L(HR=2.25,95%CI:1.17-4.30,P=0.014)、CA19- 9≥283.9 ng/mL(HR=3.23,95%CI:1.58~6.60,P=0.001)及联合化疗(HR=0.13,95%CI:0.04~0.38,P<0.001)是影响患者OS的独立预后因素。结论 SEMS- CL- 125I对LA- EHCC患者安全、有效,值得推广。TBIL及CA19- 9是影响患者术后生存的独立危险因素,术后联合新辅助化疗可获得更佳治疗效果。

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备注/Memo

备注/Memo:
(收稿日期:2018-06-20)
(本文编辑:俞瑞纲)
更新日期/Last Update: 2019-04-09