| 王俊杰,修典荣,冉维强,等.术中超声引导放射性125Ⅰ粒子植入治疗胰腺癌[J].中华放射医学与防护杂志,2005,25(5):441-443.WANG Jun-jie,XIU Dian-rong,RAN Wei-qiang,et al.Iodine-125 seed implantation for unresectable pancreatic carcinoma guided by intraoperative ultrasound[J].Chin J Radiol Med Prot,2005,25(5):441-443 |
| 术中超声引导放射性125Ⅰ粒子植入治疗胰腺癌 |
| Iodine-125 seed implantation for unresectable pancreatic carcinoma guided by intraoperative ultrasound |
| 投稿时间：2005-02-25 |
| DOI： |
| 中文关键词: 放射性125Ⅰ粒子 组织间植入 胰腺癌 |
| 英文关键词:125Ⅰ seed Interstitial implantation Pancreatic carcinoma |
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| 中文摘要: |
| 目的 探讨术中超声引导放射性125Ⅰ粒子组织间植入治疗胰腺癌的疗效。方法 22例无法切除晚期胰腺癌患者11例先行胃肠或胆肠短路术,2例行支架植入术。术前根据CT扫描图像行治疗计划计算需要剂量、需要植入粒子活度和个数。125Ⅰ粒子活度为0.40～0.70mCi/颗,肿瘤匹配周边剂量(MPD)为65～145Gy。粒子针插植,间距1～1.5cm,边缘包括肿瘤外1～1.5cm。Mick枪植入125Ⅰ粒子。粒子间距1cm。5例患者术后4周加三维适形外放疗,2～3Gy/次,5次/周,总吸收剂量39～50Gy,1例加紫杉醇增敏,1次/周,60mg/次,共3次。5例患者术后加健择化疗2周期,每21天为1个周期。结果 15例伴有上腹部疼痛患者,粒子治疗后有12例疼痛完全缓解,2例部分缓解,1例无明显缓解,有效率93.33%,平均显效时间2～3d。全组患者6例术后因复发而死亡,复发率为27.27%。全组中位生存时间6个月,其中Ⅲ期中位生存时间8个月。50%患者死于远处转移。3例术后1个月复查时发现5颗粒子迁徙到肝脏。未见出血、感染、胰腺炎和胰瘘等并发症。结论 放射性125Ⅰ粒子组织间植入治疗胰腺癌具有很好的姑息止疼疗效,部分局部晚期患者可获得长期生存,而且并发症发病率较低。 |
| 英文摘要: |
| Objective To investigate the surgical technique,efficacy and side effects of 125Ⅰ seed interstitial implantation for pancreatic carcinoma. Methods A total of 22 patients with biopsy proven unresectable adenocarcinoma of pancreas were treated with 125Ⅰ implants during laparotomy. Of them 11 patients were treated previously by a combination of bypass surgery. The stent was implanted in 2 cases 2 weeks before and 4 weeks after seed implantation. Seed needles were implanted parallelly to each other,with 1-1.5 cm apart. Mick applicator was being connected to each needle to implant seed. The radioactive activity ranged 0.40-0.70 mCi,the matched peripheral doses were 65-145 Gy. The mean number of 125Ⅰ seed was 11-78. Five cases received external beam irradiation with 3D-CRT, the doses were 39-70 Gy and 5 patients received 2 cycle of gemcitabine chemotherapy at 1000 mg/m2 on dl and d8. Results Pain was completely relieved in 12 cases,partially relieved in 2 cases,and no response was noted in one case, so the response rate was 93.33%. The median time was 2-3 d.Altogethe 27.27% of the cases died from local recurrence of pancreatic carcinoma and 50% from metastasis. The median survival time in these patients was 6 months,with a 2-year survival rate of 9.09%. The seed immigrated to liver in 3 cases.There were no serious side effects such as infection,pancreatitis,pancreatic fistula,etc. Conclusion Radioactive seed implantation was safe,high local control,mini-damage,satisfactory palliation of pain and without significant complications. |
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