摘要
目的评估经皮冷消融与^125I粒子植入联合化疗治疗晚期胰腺癌的有效性和安全性。方法对67例晚期胰腺癌患者（Ⅲ期6例，Ⅳ期61例）实施经皮冷消融与^125I粒子植入联合盐酸吉西他滨和顺铂同期化疗，评价治疗后患者的临床获益率和生存率，观察并发症的发生情况。结果全组有66例患者获得1年以上随访。6个月总生存率为84．8％，1年总生存率为33．4％，中位无进展生存时间为5．5个月，中位生存时间为11．0个月。其中Ⅲ期和Ⅳ期患者的中位无进展生存时间分别为6．3和5．5个月，中位生存时间分别为9．1和11．0个月，差异均无统计学意义（均P〉0．05）。全组完全缓解5例，部分缓解8例，稳定54例。全组患者均可评价治疗后1个月的临床获益情况，其中54例患者的疼痛评分较入组前降低≥50％，50例患者的镇痛剂级别降低或使用量较入组前减少≥50％；18例患者的体重较治疗前增加I〉2kg；KPS评分从（71．2±0．4）分增加至[（90．0±0．3）分，P〈0．05]；总获益率为80．6％。术后并发胰瘘伴中度腹腔出血1例，胆瘘1例，急性胰腺炎2例，粒子针道遗留1例，其余患者均无严重并发症发生。结论经皮冷消融与^125I粒子植入联合化疗治疗晚期胰腺癌安全、有效。
Objective To assess the efficacy and safety of percutaneous cryoablation （PCC） and 125I seed implantation combined with chemotherapy for advanced pancreatic cancer. Methods Sixty-seven patients with advanced pancreatic cancer （6 in stage m, 61 in stage IV ） received PCC and 125I seed implantation combined with concomitant gemcitabine hydrochloride and DDP chemotherapy. The clinical benefit response （CBR）, survival rate and therapy-related complications were assessed. Results All patients except one were followed up over 1 year. The 6-month and 1-year survival rates were 84.8% and 33.4%, respectively. The median progression free survival were 6.3 months and 5.5 months in the group stage Ⅲ and group stage IV （P 〉 0. 05 ）, respectively, while the overall survival was 9.1 months in the group stage Ⅲ and 11.0 months in the group stage IV （P 〉 0.05）. CR, PR and SD were achieved in 5, 8, 54 patients, respectively. Fifty-four and 50 in the 67 patients experienced a ≥50% reduction of pain score and analgesic consumption, respectively, 18 patients experienced a 〉12 kg weight gaining, and KPS was increasing from 71.2 ±0.4 to （90.0 ±0.3, P 〈0.05）, the overall benefit rate was 80.6%. No serious therapy-related complications except pancreatic fistula accompanied abdominal hemorrhage, bile leakage, acute pancreatitis and needle track seeding in 1, 1, 2 and 1 case, respectively. Conclusion Percutaneous cryoablation and ^125I seed implantation combined with chemotherapy are effective and safe for the treatment of advanced pancreatic cancer.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2012年第12期940-944,共5页
Chinese Journal of Oncology
基金
2010国家临床重点专科建设项目资助（ZX001232）
广东省医学科研基金（C2009021）
