摘要
目的分析胰腺癌超声内镜(EUS)引导下^(125)Ⅰ粒子种植术治疗晚期胰腺癌的肿瘤变化及粒子移位,并评价其治疗效果。方法对17例不能手术切除的中晚期胰腺癌患者行EUS引导下放射性^(125)Ⅰ粒子内照射治疗。所有患者治疗前均参照治疗设计系统估算期望植入粒子数量。治疗后每月复查,观察治疗前、后肿瘤变化及粒子移位、脱落等情况。结果17例患者均经EUS植入^(125)Ⅰ粒子成功。治疗前肿瘤最大长径平均值为5.4cm(3.7～9.0cm),平均植入粒子数量为27颗,平均每次植入粒子中位数为14(7～24)颗,平均植入2次。平均单颗粒子的放射性活度为(0.689±0.016)mCi。治疗后平均随访4.8个月(2～14个月)。治疗后3个月评估疗效,部分缓解5例(29.4%),疾病稳定7例(41.2%)。进展恶化5例(29.4%)。治疗后腹部平片示5例(29.4%)出现粒子丢失移位。1例脾区移位,1例肝脏移位,3例肠腔移位。治疗后粒子丢失4例。1例出现脾脏及左膈下囊肿。结论EUS引导下^(125)Ⅰ粒子内照射治疗晚期胰腺癌,可使粒子照射区域内病灶明显萎缩。但需注意放射性粒子对周围脏器的损害及粒子脱落移位等并发症的发生。
Objective To analyze the effect of endoscopic uhrasonography guided interstitial iodine 125 seed implantation in treatment of unresectable pancreatic cancer and migration of implanted seeds. Methods A total of 17 patients with unresectale pancreatic cancer underwent endoscopic uhrasonography guided interstitial iodine seeds implantation. The therapeutic plan system was used to calculate the number of implanted seeds before procedure. The patients were followed-up monthly and tumor alteration and migration number or loss of implanted seeds were investigated by abdominal plain film. Results lodine 125 seeds were successfully implanted in all patients under endoscopic uhrasonography. Before treatment, the median size of tumor was 5.4 cm（ranged from 3.7 to 9.0 cm） and the number of implanted seeds was 27, with median 14（ranged from 7 to 24） once for 2 times. The mean radioactivity per seed was（0. 689 ± 0. 016 ）mCi. The patients were follow-up of 2 to 14 months（mean 4. 8 months）. Three months after implantation, partial relief was observed in 5 patients（29. 4%）, no change in 7 patients（41.2%）and progressing in 5 patients（29.4%）. The implanted seeds migrated into spleen in 1 case, into liver in 1 case and into bowel in 3 cases. The seeds loss was found in 4 patients. Conclusions Endoscopic uhrasonography guided interstitial implantation of iodine 125 seeds in treatment of advanced pancreatic cancer may significantly inhibit tumor growth, and attention must be paled on the complications of seeds migration or loss, which will impair the nearby organs because of its radioactivity.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2007年第11期721-724,共4页
Chinese Journal of Digestion
关键词
胰腺癌
内镜超声
碘
Pancreatic neoplasms
Endosonography
Iodine
