Zhang Fu-jun, Wu Pei-hong, Zhao Ming, Huang Jin-hua, Fan Wei-jun, Gu Yang-kui, Liu Jian, Zhang Liang, Lu Ming-jian
Department of Imaging and Interventional Radiology, State Key Laboratory of Oncology in Southern China.
Zhonghua Yi Xue Za Zhi. 2006 Jan 24;86(4):223-7.
To investigate the clinical value of CT guided radioactive seed (125)I implantation in treatment of pancreatic cancer.
Twenty-six patients with pancreatic cancer 6.1 cm in size on average, 21 males and 5 females, aged 60 +/- 13 (47 - 73), underwent CT guided radioactive seed (125)I implantation. Of the 26 patients 15 had the symptom of severer abdominal pain and 10 had jaundice. Three of them were in the TNM (pTNM) stage II, 30 in the stage III, and 3 in the stage IV. Treatment plan system was used to design the distribution of the seed (125)I needed. Under CT guidance, the (125)I seeds of (2.2 - 3.3) Mq were implanted into the pancreatic cancer at a distance of 1.0 - 1.5 cm. A follow-up for 3 - 12 months was conducted.
Complete relief (CR) of the symptoms was seen in 9 patients, partial relief (PR) in 2 patients, and no change (NC) in 4 cases with an effective rate of 73.4%. The abdominal pain was relieved 3 - 7 days after the implantation. CT performed 2 months after implantation showed CR in 2 cases, PR in 13 cases, NC in 5 cases, and progression in 5 cases with an overall effective rate of 57.7%. Four patients died of local progression and 2 patients died of distant metastasis. Migration of the seeds into the liver was seen in 3 patients and slight decrease of white blood cells was seen in 1 patient during the 2-month follow-up. No severe complications, such as pancreatic leakage, acute pancreatitis, intestinal hemorrhage, etc, were found.
Safe and with minimal damage and few complications, CT guided radioactive seed (125)I implantation is effective in treatment of pancreatic cancer.
探讨CT引导下放射性粒子（125）I植入治疗胰腺癌的临床价值。
26例胰腺癌患者，平均肿瘤大小6.1cm，男21例，女5例，年龄60±13（47 - 73）岁，均接受CT引导下放射性粒子（125）I植入治疗。26例患者中，15例有较严重腹痛症状，10例有黄疸。其中TNM（pTNM）分期Ⅱ期3例，Ⅲ期30例，Ⅳ期3例。采用治疗计划系统设计所需的（125）I粒子分布。在CT引导下，将活度为（2.2 - 3.3）Mq的（125）I粒子植入胰腺癌内，粒子间距1.0 - 1.5cm。随访3 - 12个月。
症状完全缓解（CR）9例，部分缓解（PR）2例，无变化（NC）4例，有效率为73.4%。植入后3 - 7天腹痛缓解。植入后2个月CT检查显示CR 2例，PR 13例，NC 5例，进展5例，总有效率为57.7%。4例患者死于局部进展，2例患者死于远处转移。2个月随访期间，3例患者出现粒子迁移至肝脏，1例患者白细胞轻度减少。未发现胰腺漏、急性胰腺炎、肠出血等严重并发症。
CT引导下放射性粒子（125）I植入治疗胰腺癌安全、损伤小、并发症少，疗效确切。
