[1]胡小四庞青刘会春**周磊金浩王勇满忠然（蚌埠医学院第一附属医院肝胆外科,蚌埠00）.125I粒子腔内照射联合瘤体内粒子植入治疗局部进展期胰头癌[J].中国微创外科杂志,2019,01(9):794-799.
　Hu Xiaosi,Pang Qing,Liu Huichun,et al.125I Intracavitary Irradiation Combined With 125I Seeds Implantation in the Treatment of Locally Advanced Pancreatic Head Cancer[J].Chinese Journal of Minimally Invasive Surgery,2019,01(9):794-799.
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125I粒子腔内照射联合瘤体内粒子植入治疗局部进展期胰头癌()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年9期
页码:
794-799
栏目:
临床研究
出版日期:
2019-09-25

文章信息/Info

Title:
125I Intracavitary Irradiation Combined With 125I Seeds Implantation in the Treatment of Locally Advanced Pancreatic Head Cancer
作者:
胡小四庞青刘会春**周磊金浩王勇满忠然（蚌埠医学院第一附属医院肝胆外科; 蚌埠233004）
（蚌埠医学院第一附属医院肝胆外科，蚌埠233004）
Author(s):
Hu Xiaosi;  Pang Qing;  Liu Huichun;  et al.
Department of Hepatobiliary Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, China
关键词:
近距离放射; 胰头癌; 胆道支架; 125I
Keywords:
Brachytherapy; Pancreatic head carcinoma; Biliary stent; Iodine
文献标志码:
A
摘要:
目的探讨导管载入式125I粒子（SEMSCL125I）腔内照射联合瘤体内125I粒子植入治疗局部进展期胰头癌（locally advanced pancreatic head carcinoma，LAPHC）的疗效。方法回顾性分析2015年1月~2017年6月我科125I粒子照射治疗55例LAPHC的临床资料，其中SEMSCL125I腔内照射法治疗31例（腔内组），SEMSCL125I腔内照射联合瘤体内125I粒子植入治疗24例（联合组）。比较2组患者术后主要生化指标、疼痛缓解、影像学、中位生存期及并发症发生等情况。结果与腔内组相比，联合组术后3个月疼痛缓解更佳（Z=-2.170，P=0.030），肿瘤影像学缓解更佳（Z=-2.362，P=0018）。2组并发症发生率无显著差异（P>0.05），且均未出现术后出血、胰漏、粒子移位等严重并发症。与腔内组比较，联合组中位生存时间显著延长（9个月 vs. 12个月， χ2=13.302，P=0.000）。结论与单纯125I粒子腔内照射相比，125I粒子腔内照射联合实体瘤125I粒子植入对LAPHC疗效更佳，可改善患者的一般身体状况,提高支架通畅率，同时表现出更佳的肿瘤进展控制,生存质量提高及生存期延长，且并不增加并发症。
Abstract:
ObjectiveTo explore the therapeutic efficacy of metal biliary stent (SEMS) catheter loaded 125I particle (SEMSCL125I) intracavitary irradiation combined with 125I seed implantation in the solid tumor in the treatment of locally advanced pancreatic head carcinoma (LAPHC). MethodsClinical data of 55 patients with LAPHC from January 2015 to June 2017 were retrospectively analyzed. Amongst, 31 cases were treated with SEMSCL125I intracavitary irradiation (intracavitary group) and 24 cases were treated with SEMSCL125I intracavitary irradiation combined with 125I particle implantation in the solid tumor (combined group). The biochemical indexes changes, pain relief, imaging improvement, survival time and complications were compared between the two groups. ResultsPatients in the combined group had better pain improvement within 3 months (Z=-2.170, P=0.030) and better imaging remission (Z=-2.362, P=0.018). There was no significant difference in postoperative complications between the two groups (P>0.05), and no serious complications such as postoperative bleeding, pancreatic fistula or particle transposition were observed in both groups. Compared with the intracavitary group, the median survival time of patients in the combined group was significantly longer (9 months vs. 12 months, χ2=13.302, P=0.000).ConclusionsCompared with intracavitary irradiation alone, 125I intracavitary irradiation combined with seed implantation in the solid tumor is more effective for LAPHC patients. It significantly improves patients’ general conditions and stent patency, while shows better control for the tumor progression and the improvement of survival time, but does not increase the occurrence of complications.

参考文献/References:

[1]Lindquist CM, Miller FH, Hammond NA, et al. Pancreatic cancer screening. Abdom Radiol (NY),2018,43(2):264-272.
[2]Ngamruengphong S, Canto MI. Screening for pancreatic cancer. Surg Clin North Am,2016,96(6):1223-1233.
[3]Tempero MA, Malafa MP, AlHawary M, et al. Pancreatic Adenocarcinoma, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw,2017,15(8):1028-1061.
[4]The Lancet Oncology. Pancreatic cancer: cause for optimism? Lancet Oncol,2016,17(7):845.
[5]Zhang Q, Ni Q, Cancer COP, et al. Clinical analysis of 2340 cases of pancreatic cancer. Zhonghua Yi Xue Za Zhi,2004,84(3):214-218.
[6]Hezel AF, Kimmelman AC, Stanger BZ, et al. Genetics and biology of pancreatic ductal adenocarcinoma. Genes Dev,2006,20(10):1218-1249.
[7]Balaban EP, Mangu PB, Khorana AA, et al. Locally advanced, unresectable pancreatic cancer: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol,2016,34(22):2654-2668.
[8]苗毅.局部进展期胰腺癌综合治疗难点及对策.中国实用外科杂志,2017,37(7):721-723.
[9]Mirkin KA, Hollenbeak CS, Gusani NJ, et al. Trends in utilization of neoadjuvant therapy and shortterm outcomes in resected pancreatic cancer. Am J Surg,2017,214(1):80-88.
[10]Youngwirth LM, Nussbaum DP, Thomas S, et al. Nationwide trends and outcomes associated with neoadjuvant therapy in pancreatic cancer: An analysis of 18 243 patients. J Surg Oncol,2017,116(2):127-132.
[11]Peng JS, Mino J, Monteiro R, et al. Diagnostic laparoscopy prior to neoadjuvant therapy in pancreatic cancer is high yield: an analysis of outcomes and costs. J Gastrointest Surg,2017,21(9):1420-1427.
[12]汪浩, 霍彬, 霍小东,等.CT引导下放射性125I粒子植入治疗中晚期胰腺癌的有效性和安全性的Meta分析.中华放射医学与防护杂志,2017,37(7):543-549.
[13]Kozarek R. Role of preoperative palliation of jaundice in pancreatic cancer. J Hepatobiliary Pancreat Sci,2013,20(6):567-572.
[14]周磊,刘会春,李宗狂,等.经皮胆道金属支架置入姑息性治疗肝门部胆管癌.中国微创外科杂志,2015,15(11):998-1000.
[15]Hasimu A, Gu JP, Ji WZ, et al. Comparative study of percutaneous transhepatic biliary stent placement with or without Iodine125 Seeds for treating patients with malignant biliary obstruction. J Vasc Interv Radiol,2017,28(4):583-593.
[16]吴汉青,吴河水,杨智勇,等. I125粒子植入在胰腺恶性肿瘤治疗中的疗效分析.世界华人消化杂志,2009,17(28):2951-2954.
[17]Zhu HD, Guo JH, Zhu GY, et al. A novel biliary stent loaded with (125)I seeds in patients with malignant biliary obstruction: preliminary results versus a conventional biliary stent. J Hepatol,2012,56(5):1104-1111.
[18]钱震,刘会春,庞青,等.胆道支架植入联合125I粒子腔内照射治疗胰头癌临床疗效分析.现代医药卫生杂志,2018,34(8):1123-1127.
[19]白静,王俊杰,修典荣,等.术中超声引导放射性125I粒子组织间植入治疗局部晚期胰腺癌.中国微创外科杂志,2006,6(5):356-358.
[20]黄洪军,江勇,吴宝强,等.术中125I放射性粒子植入治疗不能切除晚期胰腺癌的并发症和预后分析.肝胆胰外科杂志,2014,26(4):281-284.

备注/Memo

备注/Memo:
基金项目：安徽省科技攻关项目(1501541155)**通讯作者，Email：doctorlhc2000@aliyun.com
更新日期/Last Update: 2019-12-10