摘要：
Objective To study the clinical efficacy of intra-operative implantation of 125Ⅰ particles to treat advanced pancreatic cancer,and to evaluate the treatment effects on pain relief and survival of patients.Methods A retrospective study was conducted on 53 patients who were treated in the Third Affiliated Hospital of Inner Mongolia Medical University from May 2013 to November 2016.The patients were divided into the particle implantation group (n =32,palliative operation combined with intra-operative implantation of 125Ⅰ particles or just intra-operative implantation) and the control group (n =21,palliative operation).The outcomes on pain relief and median survival after operation were compared between the 2 groups.Results Patients in the implantation group were implanted with 20 to 70 (41.4± 12.1) particles.There were no postoperative complications such as pancreatic fistula and bleeding.There was also no perioperative death.Of the 46(86.8％) patients who were followed-up,three patients were still alive at the time the data were analyzed.The postoperative survival time of the patients ranged from 3 to 27 months.For the implantation group,the median survival time was 11.5 months.The 3-,6-,12-,24-months survival rates were 100.0％,90.6％,65.6％,15.6％,respectively.Postoperative pain relief happened in 92.6％ of patients.For the control group,postoperative survival time ranged from 2 to 17 months.The median survival time was 7 months.The 3-,6-,12-,24-months survival rates were 95.2％,57.1％,9.5％,0,respectively.Postoperative pain relief happened in 16.7％ of patients.Postoperative pain relief for patients in the implantation group was significantly better than the preoperative,and than patients in the control group (both P ＜ 0.05).The Log-rank test showed a significant difference in survival between the two groups (P＜0.05).Conclusion Particle implantation significantly relieved pain and prolonged survival time of the patients.%目的 分析125Ⅰ粒子术中植入治疗晚期胰腺癌的临床疗效,评价其对患者术后疼痛缓解率及中位生存期的影响.方法 采用回顾性病例对照研究方法,收集2013年5月至2016年11月内蒙古医科大学第三附属医院手术治疗的53例晚期胰腺癌患者的临床资料.根据手术方式分为胆肠吻合术和/或胃空肠吻合术联合125Ⅰ粒子植入或仅行粒子植入组(n=32)以及姑息手术对照组(n=21).观察胰腺肿瘤相关因素及患者术后疼痛缓解率、中位生存期.结果 植入组患者术中植入粒子20～70(41.4±12.1)枚,术后均无胰瘘及出血等并发症发生.无围手术期死亡患者.术后46例患者获得随访,随访率86.8％.粒子植入组患者术后生存时间为3～ 27个月,中位生存时间11.5个月,术后3个月、6个月、12个月、24个月生存率分别为100％、90.6％、65.6％、15.6％,术后疼痛缓解率达92.6％.对照组患者术后生存时间为2～17个月,中位生存时间7个月,术后3个月、6个月、12个月、24个月生存率分别为95.2％、57.1％、9.5％、0,术后疼痛缓解率16.7％.粒子植入组患者术后的疼痛症状明显改善,与术前及对照组比较差异有统计学意义(P＜0.05).Log-rank检验显示,两组患者术后各时点生存率差异有统计学意义(P＜0.05).结论 晚期胰腺癌患者粒子植入可以明显缓解疼痛、延长中位生存时间.
