School of Radiation Medicine and Public Health, Soochow University, Suzhou, China.
Eur Radiol. 2010 Jul;20(7):1786-91. doi: 10.1007/s00330-009-1703-0. Epub 2010 Jan 13.
To examine the clinical efficacy of CT-guided radioactive iodine-125 (125I) seeds implantation treatment in patients with unresectable pancreatic cancer.
Thirty-one patients with inoperable pancreatic cancer were enrolled in this study. The 125I seeds were implanted into pancreatic tumor under CT guidance. In addition, 10 patients received routine gemcitabine and 5-fluorouracil chemotherapy 1 week after brachytherapy. Median diameter of the tumor was 5.8 cm.
Follow-up period was 2 to 25 months. Symptoms of refractory pain were significantly resolved post-interventionally (P < 0.05), and Karnofsky physical score increased dramatically (P < 0.05). Tumor response which was demonstrated on repeated CT film 2 months post-treatment revealed complete response (CR) in 3 cases, partial response (PR) in 16 cases, stable disease (SD) in 9 cases, and progressive disease (PD) in 3 cases. Overall responding rate (CR+PR) was 61.3%. Median survival time for all patients was 10.31 months. Two seeds of radioactive 125I migrated to the liver in 2 patients. There were no serious complications detected during the follow-up period.
This study suggests that CT-guided brachytherapy using 125I seeds implantation appears to be safe, effective, uncomplicated, and could produce adequate pain relief for treating unresectable pancreatic cancer.
探讨 CT 引导放射性碘-125（125I）粒子植入治疗无法切除胰腺癌的临床疗效。
本研究纳入 31 例无法手术切除的胰腺癌患者。在 CT 引导下将 125I 粒子植入胰腺肿瘤内。此外，10 例患者在放射治疗后 1 周接受常规吉西他滨和 5-氟尿嘧啶化疗。肿瘤的中位直径为 5.8cm。
随访时间为 2 至 25 个月。介入治疗后难治性疼痛症状明显缓解（P<0.05），卡氏功能状态评分显著提高（P<0.05）。治疗后 2 个月重复 CT 片显示肿瘤反应，完全缓解（CR）3 例，部分缓解（PR）16 例，疾病稳定（SD）9 例，疾病进展（PD）3 例。总缓解率（CR+PR）为 61.3%。所有患者的中位生存时间为 10.31 个月。2 例患者有 2 枚放射性 125I 种子迁移至肝脏。随访期间未发现严重并发症。
本研究表明，CT 引导下 125I 粒子植入近距离放疗治疗无法切除的胰腺癌安全、有效、并发症少，能有效缓解疼痛。
