摘要
目的:探讨computed tomography(CT)引导下125I粒子植入联合吉西他滨及顺铂(gemcitabineand cisplatin,GP)方案化疗治疗局部进展期胰腺癌的疗效.方法:88例不能手术切除局部进展期胰腺癌(locally advanced pancreatic carcinoma,LAPC)患者随机分为2组:A组(粒子植入+化疗组)45例,在局麻下行CT引导125I粒子植入术,术后10-14 d内依据患者体质情况开始行GP方案化疗,具体方案同化疗组;B组(化疗组)43例,应用"GP方案"全身化疗,具体:吉西他滨1000mg/m2(d1,8)+顺铂75 mg/m2分割呈1-4 d应用,21 d为1疗程.2组患者均按期完成4个周期化疗后进行疗效评价.患者治疗后l、2、3 mo行增强CT扫描及CA199复查,以后为每3 mo 1次,共随访30 mo.结果:A组临床受益率与B组临床受益率比较P<0.05,有统计学意义;A组平均生存时间与B组平均生存时间比较P<0.05,有统计学意义.2组88例患者中均按计划顺利完成,无1例术后及化疗后出现胰漏、出血、脏器穿孔及Ⅳ度骨髓抑制等严重不良反应.结论:CT引导下125I粒子植入联合GP方案综合治疗局部进展期胰腺癌是一种安全、有效的治疗手段.
AIM： To explore the clinical efficacy of computed tomography （CT）-guided 125I seed interstitial implantation combined with the gemcitabine and cisplatin （GP） chemotherapy regimen for the treatment of locally advanced pancreatic carcinoma. METHODS： Eighty-eight patients with unresectable locally advanced pancreatic carcinoma （LAPC） were randomly divided into two groups： A （n = 54; 125I seed implantation ＋ chemotherapy） and B （chemotherapy alone）. CT-guided 12sI seed interstitial implantation was performed under local anaesthesia. Chemotherapy was given 10-14 d after surgery. The chemotherapy protocol was gemcitabine 1000 mg/m2, dl, 8, ＋ cisplatin 75 mg/m2 dl-4 every 21 d. After four cycles of chemotherapy, the curative effect was assessed. Contrast-enhanced CT scanning and CA199 test were performed 1, 2, and 3 mo after treatment, and thereafter every 3 mo during a follow-up period of 30 mo. RESULTS： The rate of clinical benefit and mean survival time were significantly higher in group A than in group B （P 〈 0.05 for both）. No serious complications such as pancreatic leakage, bleeding, visceral perforation and grade IV bone marrow suppression were observed in either group. CONCLUSION： CT-guided 125I seed interstitial implantation combined with GP chemotherapy is safe and effective in the treatment of locally advanced pancreatic cancinoma.
出处
《世界华人消化杂志》
CAS
北大核心
2014年第10期1455-1459,共5页
World Chinese Journal of Digestology
关键词
局部进展期胰腺癌
I125粒子植入
化疗
Locally advanced pancreatic carcinoma
Iodine-125 seed implantation
Chemotherapy
