[1]徐蓉生,梅艳,赵力威,等.B超引导下术中125I粒子植入治疗晚期胰腺癌的疗效评价[J].国际放射医学核医学杂志,2016,40(6):424-428.[doi:10.3760/cma.j.issn.1673-4114.2016.06.005]
　Xu Rongsheng,Mei Yan,Zhao Liwei,et al.Evaluation of 125I particle implantation in the treatment of patients with advanced pancreatic neoplasms using B ultrasound-guided surgery[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(6):424-428.[doi:10.3760/cma.j.issn.1673-4114.2016.06.005]
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B超引导下术中125I粒子植入治疗晚期胰腺癌的疗效评价(/HTML)
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
40
期数:
2016年第6期
页码:
424-428
栏目:
论著
出版日期:
2016-11-25

文章信息/Info

Title:
Evaluation of 125I particle implantation in the treatment of patients with advanced pancreatic neoplasms using B ultrasound-guided surgery
作者:
徐蓉生;  梅艳;  赵力威;  舒斌;  何文果;  段云
610041 成都, 四川省肿瘤医院核医学科
Author(s):
Xu Rongsheng;  Mei Yan;  Zhao Liwei;  Shu Bin;  He Wenguo;  Duan Yun
Department of Nuclear Medicine, Sichuan Cancer Hospital, Chengdu 610041, China
关键词:
胰腺肿瘤; 碘放射性同位素; 近距离放射疗法; 实体肿瘤疗效评价标准
Keywords:
Pancreatic neoplasms; Iodine radioisotopes; Brachytherapy; Response evaluation criteria in solid tumors
DOI:
10.3760/cma.j.issn.1673-4114.2016.06.005
摘要:
目的 探讨B超引导下125I粒子组织间植入治疗晚期胰腺癌的临床价值。方法 97例晚期胰腺癌患者在B超引导下术中植入125I粒子，采用疼痛数字分级法、实体瘤的疗效评价标准和肿瘤标志物糖类抗原242、19-9（CA242、CA19-9）的水平进行疗效评价，随访中观察患者的并发症及不良反应等。结果 术前与术后1周、2周、1个月、3个月的患者疼痛评分比较，差异具有统计学意义（χ2=0.018、0.022、0.034、0.045，P均<0.05）；肿瘤完全缓解患者8例、部分缓解46例、稳定34例、疾病进展9例，总有效率为55.67%（54/97）；术前与术后1个月、3个月CA242、CA19-9的水平比较，差异具有统计学意义（χ2=0.027、0.029、0.017、0.022，P均<0.05）；治疗后中位生存时间为（8.0±4.5）个月，未出现严重并发症及不良反应。结论 B超引导下125I粒子植入治疗晚期胰腺癌，疗效确切，安全性高，癌痛缓解明显。
Abstract:
Objective To investigate the clinical value of 125I radioactive seed interstitial implantation in the treatment of advanced pancreatic cancer. Methods The pain classification, solid tumor response evaluation criteria, and tumor markers(carbohydrate antigen CA242 and CA19-9) were examined in 97 patients with advanced pancreatic cancer by using ultrasound-guided 125I particle implantation surgery to evaluate the complications and adverse reactions of the tool. Results Comparison among preoperative state, 1 week, 2 weeks, 1 month and 3 months post-surgery revealed significant differences in pain scores(χ2=0.018, 0.022, 0.034, 0.045, all P<0.05); 8 cases had complete remission, 46 cases had partial remission, 34 cases were stable, and 9 cases progressed. The total effectiveness rate was 55.67%(54/97); moreover, comparison among the preoperative state, 1 month, and 3 months post-surgery indicated significant differences in the serum levels of CA19-9 and CA242(χ2=0.027, 0.029, 0.017, 0.022, all P<0.05). After treatment, the median survival time was(8.0±4.5) months. No serious complications and adverse reactions were observed. Conclusion 125I radioactive particle implantation for the treatment of advanced pancreatic cancer using ultrasound-guided surgery had curative effects, high safety, and significant pain relief.

参考文献/References:

[1] Jemal A, Siegel R, Xu JQ, et al.Cancer statistics, 2010[J].CA Cancer J Clin, 2010, 60(5):277-300. DOI:10.1002/caac.20073.
[2] Baron TH, Kozarek RA.Preoperative biliary stents in pancreatic cancer-proceed with caution[J].N Engl J Med, 2010, 362(2):170-172. DOI:10.1056/NEJMe0908773.
[3] 王俊杰.放射性粒子治疗肿瘤临床应用规范[M].北京:北京大学医学出版社, 2011:47-54.Wang JJ.Specification for clinical application of radioactive particles in the treatment of cancer[M].Beijing:Peking University Medical Press, 2011:47-54.
[4] Yu YP, Yu Q, Guo JM, et al.Effectiveness and security of CT-guided percutaneous implantation of 125I seeds in pancreatic carcinoma[J/OL].Br J Radiol, 2014, 87(1039):20130642[2016-8-24].http://www.birpulications.org/doi/full/10.1259/bjr.20130642. DOI:10.1259/bjr.20130642.
[5] 孙启和, 孙彬, 杨永青.术中125I粒子植入治疗肿瘤的临床应用[J].国际放射医学核医学杂志, 2010, 34(2):102-104. DOI:10.3760/cma.j.issn.1673-4114.2010.02.011.Sun QH, Sun B, Yang YQ.The clinical application of 125I radionuclide implantation in tumor therapy[J].Int J Radiat Med Nucl Med, 2010, 34(2):102-104.
[6] Eisenhauer EA, Therasse P, Bogaerts J, et al.New response evaluation criteria in solid tumours:Revised RECIST guideline(version 1.1)[J].Eur J Cancer, 2009, 45(2):228-247. DOI:10.1016/j.ejca.2008.10.026.
[7] Strong VE, Dalai KM, Mathotra VT, et al.Initial report of laparoscopic celiac plexus block for pain relief in patients with unresectable pancreatic cancer[J].J Am Coll Surg, 2006, 203(1):129-131. DOI:10.1016/j.jamcollsurg.2006.03.020.
[8] Jian PN, Shrikhande SV, Myatra SN, et al.Neurolytic celiac plexus block:a better alternative to opioid treatment in upper abdominal malignancies:an Indian experience[J].J Pain Palliat Care Pharmacother, 2005, 19(3):15-20. DOI:10.1080/J354v19n03-04.
[9] 马蕊, 苑淑渝, 孔令海, 等.125I粒子源近距离治疗前列腺癌模型的剂量学研究[J].中华放射医学与防护杂志, 2011, 31(4):485-488. DOI:10.3760/cma.j.jssn.0254-5098.2011.4.030.Ma R, Yuan SY, Kong LH, et al.Dose distribution of I seed souress in bracbytherapy cancer model[J].Chin J Rasiol Med Prot, 2011, 31(4):485-488.
[10] Ueda M, Fukushima T, Ogawa K, et al.Synthesis and evaluation of a radioiodinated peptide probe targeting αvβ6 integrin for the detection of pancreatic ductal adenocarcinoma[J].Biochem Biophys Res Commun, 2014, 445(3):661-666. DOI:10.1016/j.bbrc.2014.02.086.
[11] Wang ZM, Lu J, Zhang LY, et al.Biological effects of low-dose-rate irradiation ofpancreatic carcinoma cells in vitro using 125I seeds[J].World J Gastroenterol, 2015, 21(8):2336-2342. DOI:10.3748/wjg.v21.i8.2336.
[12] 许旭, 赵龙栓.125碘癌肿内植入治疗晚期胰腺癌的疗效[J].中国实用医刊, 2015, 42(6):79-80. DOI:10.3760/cma.j.issn.1674-4756.2015.06.036.Xu X, Zhao LS.Effect of 125iodine cancer implanted in the treatment of advanced pancreatic cancer[J].Chin J Pract Med, 2015, 42(6):79-80.
[13] 宁峥, 李宏宇, 郭晓钟, 等.I-125粒子植入联合化疗和单纯化疗对胰腺癌疗效的荟萃分析[J].胃肠病学和肝病学杂志, 2016, 25(3):320-325. DOI:10.3969/j.issn.1006-5709.2016.03.024.Ning Z, Li HY, Guo XZ, et al.Curative effect of I-125 particles implantation combined with chemotherapy and chemotherapy alone in pancresatic cancer:a Meta-analysis[J].Chin J Gastroenterol Hepatol, 2016, 25(3):320-325.
[14] Wang H, Wang J, Jiang Y, et al.The investigation of 125I seed implantation as a salvage modality for unresectable pancreatic carcinoma[J].J Exp Clin Cancer Res, 2013, 32:106. DOI:10.1186/1756-9966-32-106.
[15] 郭道宁, 王鸿智, 王东, 等.超声导向下经皮穿刺125I植入治疗胰腺癌的临床应用[J].中国超声医学杂志, 2008, 24(1):53-55. DOI:10.3969/j.issn.1002-0101.2008.01.018.Guo DN, Wang HZ, Wang D, et al.Clinical Use of Ultrasound-guided Percutanious Implantation of 125I Particle in Pancreatic Carcinoma[J].Chin J Ultrasound Med, 2008, 24(1):53-55.

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备注/Memo

备注/Memo:
收稿日期:2016-08-25。
通讯作者:段云,Email:duan-yun@139.com
更新日期/Last Update: 1900-01-01