摘要
目的 分析评价125I粒子植入术联合化疗治疗中晚期胰腺癌临床疗效及安全性。方法 选取接受125I粒子植入术联合化疗治疗不能手术的胰腺癌患者54例,其中临床Ⅲ期组31例、Ⅳ期组23例,评价客观有效率(ORR)、疾病控制率(DCR)、无进展生存期(PFS)、总生存期(OS),生存质量改善情况、安全性及预后影响因素等。结果 全部患者均接受临床疗效和毒性反应评估,总ORR为40.74%,DCR 85.19%:其中临床Ⅲ期组ORR 51.61%,DCR 87.1%;Ⅳ期组ORR26.09%,DCR 82.61%。全部患者中位(median)PFS(mPFS)4.5个月,mOS 9个月,其中Ⅲ期组mPFS 6个月,mOS11个月;临床Ⅳ期组mPFS 4个月,mOS 8个月。单因素及多因素分析表明CA199>1210 ng/ml为影响预后的独立危险因素,差异有统计学意义(P<0.05),相对危险度2.975(95%CI 1.590~568.0);单因素分析结果显示年龄<60岁为保护性因素(P=0.044),相对危险度0.557(95%CI 0.315~0.985)。治疗后ECOG评分下降35例,平均下降(0.593±0.765)分;疼痛评分(NRS)下降47例,平均下降(2.167±1.489)分。治疗相关Ⅲ级以上不良反应发生率11.11%。结论 经皮穿刺125I粒子植入术联合化疗治疗中晚期胰腺癌显示具有较好的肿瘤局部控制率,患者生存质量改善显著。
Objective To analyze and evaluate the clinical efficacy and safety of 125I seed implantation combined with chemo-therapy in the treatment of advanced pancreatic cancer.Methods A retrospective analysis was performed on 54 patients with inoperable pancreatic cancer who received 125I seed implantation combined with chemotherapy,including 31 patients in stage III group and 23 patients in stage IV group.Objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS)and overall survival(OS),quality of life improvement,safety and prognostic factors were evaluated.Results All pa-tients were evaluated for clinical efficacy and toxicity.The total ORR was 40.74% and DCR was 85.19%,including 51.61%and 87.1%in the stage III clinical group.The ORR and DCR of stageⅣgroup were 26.09%and 82.61%respectively.All patients had mPFS 4.5m and mOS 9m,and the stageⅢgroup had mPFS 6m and mOS11 m.Clinical stageⅣgroup had mPFS4m,mOS 8m.Univariate and multivariate analysis showed that CA199 greater than 1210 ng/ml was an independent risk factor for prognosis(P<0.005),and the relative risk was 2.975(95%CI 1.590~568.0).Univariate analysis showed that age less than 60 years old was the protective factor(P=0.044),and relative risk was 0.557(95%CI 0.315~0.985).After treatment,ECOG score de-creased in 35 of 54 patients,with an average decrease of(0.593±0.765)points.Pain score(NRS)decreased in 47 cases,with an average decrease of(2.167±1.489)points.Treatment-related grade 3 or above adverse reactions were 11.11%.Conclu-sion Percutaneous 125I particle implantation combined with chemotherapy in the treatment of advanced pancreas showed a better local tumor control rate,and the patients'quality of life improved significantly.
作者
季德林
吕维富
谢韬
施长杲
周磊
JI Delin;LYU Weifu;XIE Tao;SHI Changgao;ZHOU Lei(Department of Interventional Oncology,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230031,China;Department of imaging,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230031,China)
出处
《医学影像学杂志》
2024年第8期82-85,共4页
Journal of Medical Imaging
基金
安徽省高校协同创新项目(编号:GXXT-2022-031)。
关键词
胰腺癌
125I粒子
组织间内照射
介入性
放射学
Pancreatic cancer
125I seed
Interstitial irradiation
Interventional radiology
