[1]王忠敏 黄钢 陈克敏 陆健 贡桔 郑云峰 张丽云.CT引导下~(125)I放射性粒子治疗胰腺癌的疗效观察[J].介入放射学杂志,2009,(09):668.
　WANG Zhong-min HUANG Gang CHEN Ke-min LU Jian GONG Ju ZHENG Yun-feng ZHANG Li-yun.Clinical efficacy of CT-guided ~(125)I seed implantation therapy for advanced pancreatic cancer[J].journal interventional radiology,2009,(09):668.
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CT引导下~(125)I放射性粒子治疗胰腺癌的疗效观察()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2009年09期
页码:
668
栏目:
非血管介入
出版日期:
2009-09-15

文章信息/Info

Title:
Clinical efficacy of CT-guided ~(125)I seed implantation therapy for advanced pancreatic cancer
作者:
王忠敏 黄钢 陈克敏 陆健 贡桔 郑云峰 张丽云
王忠敏,陆健,贡桔,郑云峰,张丽云,WANG Zhong-min,LU Jian,GONG Ju,ZHENG Yun-feng,ZHANG Li-yun(上海交通大学医学院附属瑞金医院卢湾分院介入科,200020) 黄钢,HUANG Gang(上海交通大学医学院) 陈克敏,CHEN Ke-min(上海交通大学医学院附属瑞金医院放射科)
Author(s):
WANG Zhong-min HUANG Gang CHEN Ke-min LU Jian GONG Ju ZHENG Yun-feng ZHANG Li-yun
关键词:
胰腺癌 CT引导 ~(125)I粒子 内照射治疗 pancreatic cancer CT-guidance iodine~(125)I brachytherapy
分类号:
R730.55
摘要:
目的 探讨CT引导下~(125)I放射性粒子植入治疗胰腺癌技术的可行性和疗效.方法 对40例不能手术切除的晚期胰腺癌患者作CT引导下植入~(125)I粒子治疗.术前采用治疗计划系统(TPS)重建胰腺肿瘤的三维立体图像,计算出植入的~(125)I粒子数目、空间分布和剂量分布率,在CT引导下将~(125)I粒子植入胰腺肿瘤内,采用~(125)I粒子活度为0.5～0.8 mCi/颗,相隔1.0 cm植入,避开血管和胰管等周围重要脏器.放射性粒子的肿瘤匹配周边剂量(matched peripheral dose,MPD)为60～140 Gy.中位植入粒子36颗(18～68颗),术后即刻行CT扫描进行粒子质量验证.术后1周10例患者给予吉西他滨和5-Fu动脉灌注化疗,3～4个疗程.结果 全组肿瘤平均直径为4.9 cm.治疗后随访2～28个月,术后患者顽固性疼痛症状明显缓解(P<0.05),Karnofsky评分显著提高(P<0.05).平均术后2～5 d疼痛开始缓解.术后2个月CT随访,肿瘤完全缓解(CR)3例,部分缓解(PR)20例,无变化(NC)14例,进展(PD)3例.总有效率(CR+PR)为57.5%.全组中位生存时间为10.2个月.Ⅱ、Ⅲ、Ⅳ期粒子植入术后中位生存期分别为14.7、10.9及7.1个月;6个月和12个月累计生存率分别为100%、88%、62%和70%、41%、0.其中5例合并肝转移患者,则同时行动脉栓塞治疗.3例患者术后随访发现4颗粒子迁移到肝脏内.在随访过程中未见上消化道出血、胰腺炎、胰瘘及放射性肠炎等并发症.结论 CT引导下植入~(125)I放射性粒子治疗胰腺癌,近期疗效确切,具有良好的止痛效果,是一种安全、有效、并发症发生率低的微创治疗方法,粒子治疗后联合化疗药物动脉灌注治疗,有望提高疗效,远期疗效尚待进一步随访和观察.

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更新日期/Last Update: 2009-09-15