125I粒子植入术联合化疗治疗中晚期胰腺癌疗效分析
The clinical effect of percutaneous 125I implantation combined with chemotherapy in advanced pancreatic cancer
季德林 1吕维富 2谢韬 1施长杲 1周磊1
作者信息
- 1. 中国科学技术大学附属第一医院西区(安徽省肿瘤医院)肿瘤介入科 安徽 合肥 230031
- 2. 中国科学技术大学附属第一医院影像科 安徽 合肥 230031
- 折叠
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ORR 26.09%,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.
Abstract
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 stage Ⅳ group were 26.09％and 82.61％respectively.All patients had mPFS 4.5m and mOS 9m,and the stage Ⅲ group had mPFS 6m and mOS11 m.Clinical stage Ⅳ group 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.
关键词
胰腺癌/125I粒子/组织间内照射/介入性,放射学Key words
Pancreatic cancer/125I seed/Interstitial irradiation/Interventional radiology引用本文复制引用
基金项目
安徽省高等学校协同创新项目(GXXT-2022-031)
出版年
2024
NETL
NSTL
万方数据