Department of Oncology, Suzhou Hospital of Nanjing Medical University, Suzhou, China.
Department of Pharmacy, Suzhou Hospital of Nanjing Medical University, Suzhou, China.
J Invest Surg. 2022 Jan;35(1):1-6. doi: 10.1080/08941939.2020.1805057. Epub 2020 Aug 30.
To compare the efficacy and safety of iodine-125 seed interstitial brachytherapy and local chemotherapy perfusion in treatment of advanced pancreatic cancer.
The present open prospective randomized control study included a total of 165 cases of advanced pancreatic cancer patients who were admitted in our hospital during December 2016 to April 2019. All patients were randomized into two groups with 84 cases in iodine-125 group and 81 cases in chemotherapy perfusion group. Basic clinical characteristics and demographic data were collected. The main outcome was the tumor efficiency. The pain condition was measured by visual analogue scale (VAS) and the Karnofsky score was also measured at different time points, before the treatment, 1 d, 7 d, 14 d, 1 mon, 2 mon and 3 mon after treatment. Serum levels of CEA, CA19-9 and CA50 were measured by immunochemiluminescence. The overall survival was analyzed by K-M curve.
The ratio of partial remission patients was significantly higher, and the ratio of stable disease (SD)+progressive disease patients was also remarkably lower in iodine-125 group than the chemotherapy perfusion group. The mean VAS scores decreased markedly after treatment and were significantly lower and the mean Karnofsky scores were remarkably higher in iodine-125 group than the chemotherapy perfusion group. The levels of CA19-9 and CA50 were remarkably lower in iodine-125 group, however no significant difference was found for CEA. The survival analysis by K-M curve showed the iodine-125 patients had longer overall survival time than the chemotherapy perfusion group. No infection, pancreatic fistula, biliary fistula, intestinal fistula, gastrointestinal obstruction or radiation enteritis was found in both groups.
Iodine-125 seed interstitial brachytherapy could achieve better efficacy with no increased side complications than chemotherapy perfusion in advanced pancreatic cancer.
比较碘-125 籽间内放疗与局部化疗灌注治疗晚期胰腺癌的疗效和安全性。
本研究为开放前瞻性随机对照研究，共纳入 2016 年 12 月至 2019 年 4 月我院收治的 165 例晚期胰腺癌患者，随机分为碘-125 组 84 例和化疗灌注组 81 例。收集两组患者的基本临床特征和人口学资料。主要观察指标为肿瘤疗效。采用视觉模拟评分法（VAS）评估疼痛情况，于治疗前、治疗后 1 d、7 d、14 d、1 个月、2 个月、3 个月分别测量 Karnofsky 评分。采用免疫化学发光法检测血清 CEA、CA19-9 和 CA50 水平。采用 K-M 曲线分析总生存期。
碘-125 组部分缓解患者比例明显高于化疗灌注组，稳定（SD）+进展（PD）患者比例明显低于化疗灌注组。治疗后，碘-125 组 VAS 评分明显下降，Karnofsky 评分明显升高，与化疗灌注组比较差异均有统计学意义（P<0.05）。治疗后碘-125 组 CA19-9 和 CA50 水平明显降低，与化疗灌注组比较差异有统计学意义（P<0.05），而两组 CEA 水平比较差异无统计学意义（P>0.05）。K-M 曲线生存分析显示，碘-125 组患者总生存时间长于化疗灌注组。两组均未发生感染、胰瘘、胆瘘、肠瘘、胃肠道梗阻或放射性肠炎等并发症。
碘-125 籽间内放疗治疗晚期胰腺癌的疗效优于化疗灌注，且未增加不良反应。
