杜鹏,卢伟,蒋富强,杨剑.同轴穿刺植入125I粒子治疗局部晚期胰腺头颈部癌的安全性及有效性[J].中国介入影像与治疗学,2020,17(9):548-551
同轴穿刺植入125I粒子治疗局部晚期胰腺头颈部癌的安全性及有效性
Safety and efficacy of coaxial puncture 125I particle implantation in treatment of pancreatic head and neck cancer
投稿时间:2020-03-19  修订日期:2020-08-07
DOI:10.13929/j.issn.1672-8475.2020.09.008
中文关键词:  胰腺肿瘤  放射学,介入性  近距离放射疗法  间质内照射
英文关键词:pancreatic neoplasms  radiology, interventional  brachytherapy  interstitial irradiation
基金项目:
作者单位E-mail
杜鹏 中国人民解放军总医院第六医学中心介入医学科, 北京 100048  
卢伟 中国人民解放军总医院第六医学中心介入医学科, 北京 100048 luwei6702@126.com 
蒋富强 中国人民解放军总医院第六医学中心介入医学科, 北京 100048  
杨剑 中国人民解放军总医院第六医学中心介入医学科, 北京 100048  
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中文摘要:
      目的 观察同轴穿刺植入125I粒子治疗局部晚期胰腺头颈部癌的安全性及有效性。方法 回顾性分析21例局部晚期胰腺头颈部癌患者,均通过放射治疗计划系统(TPS)制定术前计划,同平面模拟扇形布源系统。采用同轴穿刺技术植入125I粒子,术中实时调整手术方案。术后将CT图像导入TPS行剂量验证。术后2、4、6个月行腹部CT扫描,评价治疗有效率及局部控制率,并统计术中及术后并发症。结果 所有患者均顺利完成手术。术后2、4、6个月治疗有效率为38.10%(8/21)、47.62%(10/21)及52.38%(11/21),局部控制率为95.24%(20/21)、80.95%(17/21)及80.95%(17/21)。术中手术相关并发症包括局部腹腔出血2例,皮下软组织血肿2例,误穿胰管1例。术后10例出现发热,3例食欲下降;急性放射性肠炎0级18例,Ⅰ级3例。结论 采用同轴穿刺技术植入125I粒子治疗局部晚期胰腺头颈部癌的安全性及有效性均较好。
英文摘要:
      Objective To observe the safety and efficacy of coaxial puncture 125I seed implantation in treatment of locally advanced pancreatic head and neck cancer. Methods Totally 21 patients with locally advanced pancreatic cancer were retrospectively analyzed. Preoperative planning was performed with treatment planning system (TPS) and fan-shaped distributed system simulated in the same plane. 125I seeds were implanted using coaxial puncture technology, and was operative plan real-timely adjusted during operation. After operation, CT images were imported into TPS for dose verification. Abdominal CT scanning were performed 2, 4 and 6 months after operation to evaluate the treatment efficiency and local control rate, and intraoperative and postoperative complications were counted. Results The operations were successfully completed in all patients. The effective rate of treatment 2, 4 and 6 months after operation was 38.10% (8/21), 47.62% (10/21) and 52.38% (11/21),and the local control rate was 95.24% (20/21), 80.95% (17/21) and 80.95% (17/21), respectively. Intraoperative complications included 2 cases of local abdominal hemorrhage, 2 cases of subcutaneous soft tissue hematoma and wrong puncture of pancreatic duct in 1 case. Post operation, fever and appetite loss occurred in 10 and 3 cases, respectively. Among 21 patients, grade 0 and grade Ⅰ acute radiation enteritis were observed in 18 and 3 cases, respectively. Conclusion Coaxial puncture 125I particle implantation technology is safe and effective for treatment of locally advanced pancreatic head and neck cancer.
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