Objective To study the clinical curative effect of CT-guided radioactive 125I implanted combined with TS-1 for the treatment of middle-late pancreatic cancer. Methods A retrospective analysis was conducted on the results of 15 patients with advanced pancreatic carcinoma from October 2010 to October 2012,CT-guided 125I seed interstitial implantation was carried out,then all patients were received TS-1 treatment. The cancer treatment effect,quality of life,pain relief and survival rate improvement were evaluated. Results 15 patients were implanted 374 particles, an average of 24.93(16-43). The average dose was (88.71士27.39)Gy, surface activity 0.6 mCi. Follow-up CT as a result two months after implantation,complete reminssion(CR) was obtained in 1 case,partial remission(PR) was obtained in 6 cases,no change(NC) was obtained in 4 cases, progressive deterioration(PD) was obtained in 4 cases. The overall effective rate (CR十PR) was 46.67%. A median survival time of patients was 11 months. 6 months cumulative survival rate is 80.0%, 12 months cumulative survival rate is 40.0%,24 months cumulative survival rate is 13.3%. 1 case expe-rienced serious gastrointestinal bleeding,the other of patierts have no serious complications (such as pancreatitis, intestinal hemorrhage,radiation colitis,etc) occur during the operation of all the patients. Conclusion CT-guided radioactive 125I implanted combined with TS-1 has quite satisfactory short-term efficacy,and recent analgesic effect is also obviously,which is a safe and effective method of middle-late minimally invasive treatment of pancreatic cancer.%目的 探讨 125I粒子植入联合替吉奥治疗中晚期胰腺癌的临床疗效. 方法 回顾性分析2010年10月~2012年10月15例中晚期胰腺癌患者,所有患者行CT引导下植入 125I放射性粒子治疗,术后行替吉奥方案化疗.观察患者肿瘤治疗效果、 生存质量、 疼痛缓解情况及生存率的改善情况. 结果 15例患者总植入放射性粒子374粒,平均24.93粒(16~43粒),平均剂量为(88.71士27.39)Gy,表面活度0.6 mCi. 2个月后CT复查,达到完全缓解1例,部分缓解6例,疾病稳定4例,进展恶化4例.肿瘤治疗总有效率为46.67%.平均术后3-4天疼痛开始缓解,有效率为80%,治疗后疼痛较治疗前明显缓解. 所有病例中位生存时间为11个月(95%CI:5.74-16.26). 6个月累计生存率为80.0%,1年累计生存率为40.0%,2年生存率为13.3%.随访中1例出现严重消化道出血,余患者无胰腺炎、胃肠道出血、放射性肠炎等严重并发症发生. 结论 125I粒子植入联合替吉奥对于中晚期胰腺癌近期治疗效果较好,其止痛效果明确,是一种安全微创治疗中晚期胰腺癌的方法.
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