【摘要】：目的探索碘-125粒子條腔內(nèi)近程放射治療局部進(jìn)展期胰腺導(dǎo)管腺癌伴梗阻性黃疸的安全性及可行性。方法對(duì)2010年1月至2015年2月復(fù)旦大學(xué)附屬中山醫(yī)院介入科收治的17例局部進(jìn)展期(4例為T(mén)4N0M0,13例為T(mén)4N1M0)胰腺導(dǎo)管腺癌伴梗阻性黃疸患者行碘-125粒子條腔內(nèi)近程放射治療的臨床資料進(jìn)行回顧性分析。用配對(duì)t檢驗(yàn)分析患者術(shù)前、術(shù)后肝功能變化。碘-125粒子條放射劑量由碘-125粒子條放射區(qū)域分布計(jì)算軟件(0.1版,復(fù)旦大學(xué)影像研究所)根據(jù)美國(guó)醫(yī)學(xué)物理協(xié)會(huì)TG43U1近程放射公式計(jì)算。用Kaplan-Meier曲線分析無(wú)梗阻生存期和累計(jì)生存期。術(shù)后并發(fā)癥根據(jù)美國(guó)國(guó)立癌癥研究所通用毒性標(biāo)準(zhǔn)4.0版評(píng)估。結(jié)果碘-125粒子條累計(jì)劑量(r=5 mm,240天)為164.19~170.05 Gy,平均為167.38Gy。平均、中位無(wú)梗阻生存期分別為(9.62±1.47)個(gè)月(95%CI:6.73~12.50)和(7.26±1.71)個(gè)月(95%CI:3.90~10.62),平均、中位總生存期分別為(9.89±1.59)個(gè)月(95%CI:6.78~13.00)和(7.26±1.71)個(gè)月(95%CI:3.90~10.62)�；颊咝g(shù)前、術(shù)后總膽紅素和直接膽紅素差異具有統(tǒng)計(jì)學(xué)意義。研究中2例患者發(fā)生3級(jí)術(shù)后并發(fā)癥,1例患者發(fā)生4級(jí)并發(fā)癥。1例患者出現(xiàn)支架再狹窄(5.9%)。結(jié)論碘-125粒子條腔內(nèi)近程放射治療是局部進(jìn)展期胰腺導(dǎo)管腺癌伴梗阻性黃疸的一種安全可行的治療方法。
[Abstract]:Objective to investigate the safety and feasibility of iodine-125 particle intracavitary short-range radiotherapy in the treatment of locally advanced pancreatic ductal carcinoma with obstructive jaundice. Methods from January 2010 to February 2015, 17 patients (4 patients with T4N0M0, 13 patients with T4N1M0) with pancreatic ductal carcinoma complicated with obstructive jaundice were treated with iodine-125 particle intracavitary short-range radiotherapy in the Department of intervention, Zhongshan Hospital affiliated to Fudan University. The clinical data of radiation therapy were analyzed retrospectively. The changes of liver function before and after operation were analyzed by matched t test. The radiation dose of iodine-125 particle strip is calculated by the software for calculating the radiation area distribution of iodine-125 particle strip (version 0.1, Institute of Imaging, Fudan University) according to the TG43U1 short-range radiation formula of the American Association of Medical Physics. Kaplan-Meier curve was used to analyze the survival time without obstruction and cumulative survival time. Postoperative complications were assessed according to version 4.0 of the National Cancer Institute General toxicity Standard. Results the cumulative dose of iodine-125 particle strip (r 鈮，

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