第一部分經(jīng)動脈灌注化療治療胰腺癌的臨床療效分析背景與目的:胰腺癌是常見消化道惡性腫瘤,死亡率居惡性腫瘤第7位。約80%的患者診斷時已為進(jìn)展期胰腺癌,失去根治性外科手術(shù)切除的機(jī)會,5年生存率僅約3%。全身化療是進(jìn)展期胰腺癌患者的首選治療方法,但需要充分評估患者年齡、合并癥、一般狀態(tài)及耐受性。腫瘤消耗、疼痛、厭食、惡病質(zhì)狀態(tài)及化療副作用等因素可導(dǎo)致部分進(jìn)展期胰腺癌患者無法耐受全身化療。此外,關(guān)鍵基因突變、信號通路調(diào)控異常及局部缺氧微環(huán)境等因素可引起化療藥物耐藥,進(jìn)而導(dǎo)致全身化療失敗。無法耐受全身化療及全身化療失敗的胰腺癌患者治療方法十分有限,預(yù)后極差,最佳支持治療后患者的中位生存期僅約2.3個月。經(jīng)動脈灌注化療通過導(dǎo)管將化療藥物直接灌注到腫瘤供血動脈,提高了局部化療藥物濃度,同時降低了全身化療藥物濃度,并發(fā)癥少,患者耐受性好�？煽刂圃l(fā)腫瘤生長,減輕腹痛等癥狀,提高患者生活質(zhì)量及延長患者生存期。對于合并肝轉(zhuǎn)移的胰腺癌患者,經(jīng)動脈灌注化療過程中在腹腔干或肝總動脈灌注化療藥物是有效的治療方法。此外,在全身化療失敗的患者中,全身化療失敗的藥物在局部灌注仍可達(dá)到控制腫瘤生長的作用。因此,經(jīng)動脈灌注... 

【文章來源】：北京協(xié)和醫(yī)學(xué)院北京市 211工程院校 985工程院校

【文章頁數(shù)】：86 頁

【學(xué)位級別】：博士

【部分圖文】：

圖１－１?ＴＡＩ腫瘤控制病例：患者女，４３歲，診斷胰腺癌伴肝轉(zhuǎn)移，ＴＮＭ分期ＩＶ期：??ＥＣ０Ｇ評分１分

圖１－２腫瘤無進(jìn)展生存時間分析曲線??

?５００??Ｔｉｍｅ?（Ｄａｙｓ）??圖１－２腫瘤無進(jìn)展生存時間分析曲線??１００－１￣￣Ｃ???＊１＿?－４－?Ｃｅｎｓｏｒｅｄ??８０－?＇??ｒ?＼??。??°＼?ｓ?￣ｉ??Ｔｉｍｅ?（Ｄａｙｓ）??圖１－３患者生存分析曲線??２０??

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