介入放射学杂志2024,Vol.33Issue(8) :878-884.DOI:10.3969/j.issn.1008-794X.2024.08.013

125I粒子联合动脉灌注化疗对中晚期胰腺癌患者的临床疗效观察

Clinical effect of 125I seeds implantation combined with arterial infusion chemotherapy for patients with advanced pancreatic cancer

周诚 沈天皓 蒋霆辉 俞雪 刘艳
介入放射学杂志2024,Vol.33Issue(8) :878-884.DOI:10.3969/j.issn.1008-794X.2024.08.013

125I粒子联合动脉灌注化疗对中晚期胰腺癌患者的临床疗效观察

Clinical effect of 125I seeds implantation combined with arterial infusion chemotherapy for patients with advanced pancreatic cancer

周诚 1沈天皓 1蒋霆辉 1俞雪 1刘艳1
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作者信息

  • 1. 200062 上海 上海中医药大学附属普陀医院肿瘤介入科
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摘要

目的 评价125I粒子联合动脉灌注化疗(transcatheter arterial infusion,TAI)对中晚期胰腺癌(pancreaticcarcinoma,PC)的临床疗效.方法 将符合入组的76例患者采用信封封藏法随机分为观察组、对照组.最终纳入67例,观察组为125I粒子联合TAI(31例),对照组为TAI(36例),治疗3个疗程后比较两组的临床疗效、疼痛评分、梗阻性黄疽(obstructive jaundice,OJ)发生率及生存期.结果 观察组客观缓解率(ORR)为48.4%,对照组为25.0%,差异有统计学意义(P<0.05);观察组疾病控制率(DCR)为83.9%,对照组为66.7%,差异无统计学意义(P>0.05).两组患者术后1、3个月的疼痛评分均较前下降(P<0.05),但观察组疼痛评分下降明显高于对照组(P<0.05).观察组、对照组疼痛缓解率分别为23.06%、13.4%,差异有统计学意义(P=0.0252);观察组、对照组OJ发生率分别为19.4%、50.0%,差异有统计学意义(P<0.05);观察组、对照组患者中位生存期分别为7.9个月、5.1个月,差异有统计学意义(P<0.05).两组患者术后1、3个月CA199水平均有所下降,差异有统计学意义(P<0.05).两组患者恶心呕吐、腹泻和白细胞减少等不良反应发生率比较,差异无统计学意义(P>0.05).结论 125I粒子联合TAI可以有效缓解中晚期PC癌痛,延长生存时间,且安全性良好,值得临床推广.

Abstract

Objective To evaluate the clinical efficacy of 125I seeds implantation combined with transcatheter arterial infusion(TAI)in treating advanced pancreatic carcinoma(PC).Methods By using envelope sealing method,76 patients who met enrollment criteria were divided into observation group and control group.Finally,a total of 67 patients were enrolled in this study.The observation group had 31 patients and the patients received 125I seeds implantation combined with TAI therapy,and the control group had 36 patients and the patients received TAI therapy.After 3 courses of treatment,the clinical efficacy,pain score,incidence of obstructive jaundice(OJ),and survival time were compared between the two groups.Results In the observation group and the control group,the objective response rate(ORR)was 48.4%and 25.0%respectively,and the difference was statistically significant(P<0.05);the disease control rate(DCR)was 83.9%and 66.7%respectively,and the difference was not statistically significant(P>0.05).In both groups,the postoperative one-month and 3-month pain scores were decreased obviously when compared with the preoperative values(P<0.05),but the reduction of pain score in the observation group was more obvious than that in the control group(P<0.05).In the observation group and the control group,the pain relief rates were 23.06%and 13.4%respectively,and the difference was statistically significant(P=0.0252);the incidences of OJ were 19.4%and 50.0%respectively,and the difference was statistically significant(P<0.05);the median survival time was 7.9 months and 5.1 months respectively,and the difference was statistically significant(P<0.05).In both groups,the postoperative one-month and 3-month CA199 levels were decreased,and the difference was statistically significant(P<0.05).No statistically significant difference in the incidences of adverse reactions such as nausea,vomiting,diarrhea and leukopenia existed between the two groups(P>0.05).Conclusion 125I seeds implantation combined with TAI therapy can effectively relieve cancer pain,prolong survival time in patients with advanced PC,and it is clinically safe.Therefore,this therapy is worthy of clinical promotion.

关键词

胰腺癌/125I粒子/动脉灌注化疗

Key words

pancreatic cancer/125I seed/arterial infusion chemotherapy

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基金项目

上海市卫生健康委青年人才项目(2022YQ037)

上海市卫生健康委临床专项(20204Y0135)

普陀区科技创新项目(ptkwws202210)

普陀区中心医院"临床匠才"人才项目(2022-RCJC-07)

出版年

2024
介入放射学杂志
上海市医学会

介入放射学杂志

CSTPCDCSCD北大核心
影响因子:1.866
ISSN:1008-794X
参考文献量23
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