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射频消融治疗局部进展期胰腺癌的前瞻性研究。

A prospective study on radiofrequency ablation locally advanced pancreatic cancer.

机构信息

Department of Surgery, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

出版信息

Hepatobiliary Pancreat Dis Int. 2010 Jun;9(3):306-11.

Abstract

BACKGROUND

Radiofrequency ablation (RFA) has been suggested as a new treatment option for patients with locally advanced cancer. This study aimed to prospectively evaluate the efficacy and safety of intraoperative RFA in patients with unresectable, locally advanced, non-metastatic carcinoma of the pancreatic head.

METHODS

RFA was the first step of the surgical procedure and was carried out on the mobilized pancreatic head followed by biliary by-pass and gastrojejunal-anastomosis. Intra- and post-operative morbidity and mortality, performance status, pain control, quality of life, and survival at 24 months were evaluated.

RESULTS

Seven patients (3 men and 4 women; median age 66 years, range 47-80 years) were studied and 4 were eligible for treatment. The RFA procedure was carried out in 3 of the 4 patients; in one patient it was not carried out because of the upstaging of the neoplasm. In all 3 patients RFA achieved complete necrosis of the lesion. A biliary fistula developed 7 days after the procedure in one patient; all 3 patients developed ascites 8.6 days (range 7-9 days) on average after RFA. All patients died respectively, at 3, 4, and 5 months after the treatment.

CONCLUSIONS

In our experience, RFA is a feasible procedure, but it presents a very high rate of postoperative complications. Moreover, pain control, life quality and survival rate are poor. The few data suggest no impact on survival.

摘要

背景

射频消融(RFA)已被提议作为局部晚期癌症患者的一种新的治疗选择。本研究旨在前瞻性评估术中 RFA 在不可切除、局部晚期、非转移性胰头癌患者中的疗效和安全性。

方法

RFA 是手术的第一步,在移动的胰头进行,随后进行胆道旁路和胃空肠吻合。评估围手术期发病率和死亡率、体能状态、疼痛控制、生活质量以及 24 个月时的生存率。

结果

7 例患者(3 男 4 女;中位年龄 66 岁,范围 47-80 岁)入组,4 例符合治疗条件。4 例患者中有 3 例进行了 RFA 治疗;1 例由于肿瘤分期升级未进行。在所有 3 例患者中,RFA 均实现了病变的完全坏死。1 例患者在手术后 7 天出现胆瘘;所有 3 例患者在 RFA 后平均 8.6 天(范围 7-9 天)出现腹水。所有患者分别在治疗后 3、4 和 5 个月死亡。

结论

根据我们的经验,RFA 是一种可行的治疗方法,但术后并发症发生率非常高。此外,疼痛控制、生活质量和生存率较差。为数不多的数据表明其对生存率没有影响。

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