经皮胆道支架联合近距内放疗治疗不能手术切除的肝门胆管癌
发布时间：2019-05-29 19:14
【摘要】：目的探讨经皮胆道支架联合近距内放疗治疗不能手术切除的肝门胆管癌的可行性、安全性和有效性,以及联合治疗对患者黄疸复发和生存期的影响。方法对2014年2月—2015年12月上海仁济医院肿瘤介入科收治的21例不能手术切除而接受经皮胆道支架联合近距内放疗的肝门胆管癌患者及该院同期单纯胆道引流或金属裸支架植入的患者28例进行回顾性分析。观察手术成功率、退黄效果及术后并发症发生率,比较两组患者生存期和黄疸复发时间的差异。结果 21例联合治疗患者共植入金属裸支架32枚,放射性125I粒子580颗,手术成功率100%,治疗有效率85.7%,术后早期并发症发生率9.5%,无手术相关死亡发生。联合治疗组患者术后中位黄疸复发时间为344 d而单纯胆道引流或金属裸支架植入患者的中位黄疸复发时间为193 d(P=0.035)。联合治疗组患者中位生存期387 d明显长于单纯胆道引流或金属裸支架植入患者的256 d(P=0.022)。结论经皮胆道支架联合近距离内放疗作为不能手术切除的肝门胆管癌患者的姑息治疗方案安全有效可行,联合治疗能够推迟肝门胆管癌患者的黄疸复发及延长生存期。
[Abstract]:Objective to investigate the feasibility, safety and efficacy of percutaneous bile duct stent combined with short distance radiotherapy in the treatment of unresectable hilar bile duct carcinoma, and the effect of combined therapy on jaundice recurrence and survival time. Methods from February 2014 to December 2015, 21 patients with hilar bile duct carcinoma who could not be surgically resected and treated with percutaneous bile duct stent combined with short distance internal radiotherapy were treated in the Department of tumor intervention, Shanghai Renji Hospital, and the patients with hilar bile duct carcinoma were treated with simple bile duct drainage or drainage at the same time. 28 patients with bare metal stent implantation were analyzed retrospectively. the results were as follows: (1) 28 patients were treated with bare metal stent implantation. The success rate of operation, the effect of yellowing and the incidence of postoperative complications were observed, and the differences of survival time and recurrence time of jaundice between the two groups were compared. Results A total of 32 bare metal stents and 580 radioactive 125i seeds were implanted in 21 patients. The success rate of operation was 100%, the effective rate was 85.7%, the incidence of early postoperative complications was 9.5%, and no operation-related death occurred. The median recurrence time of jaundice in the combined treatment group was 344 days, while that in the patients with simple bile drainage or bare metal stent implantation was 193 days (P 鈮，
本文编号：2488157
[Abstract]:Objective to investigate the feasibility, safety and efficacy of percutaneous bile duct stent combined with short distance radiotherapy in the treatment of unresectable hilar bile duct carcinoma, and the effect of combined therapy on jaundice recurrence and survival time. Methods from February 2014 to December 2015, 21 patients with hilar bile duct carcinoma who could not be surgically resected and treated with percutaneous bile duct stent combined with short distance internal radiotherapy were treated in the Department of tumor intervention, Shanghai Renji Hospital, and the patients with hilar bile duct carcinoma were treated with simple bile duct drainage or drainage at the same time. 28 patients with bare metal stent implantation were analyzed retrospectively. the results were as follows: (1) 28 patients were treated with bare metal stent implantation. The success rate of operation, the effect of yellowing and the incidence of postoperative complications were observed, and the differences of survival time and recurrence time of jaundice between the two groups were compared. Results A total of 32 bare metal stents and 580 radioactive 125i seeds were implanted in 21 patients. The success rate of operation was 100%, the effective rate was 85.7%, the incidence of early postoperative complications was 9.5%, and no operation-related death occurred. The median recurrence time of jaundice in the combined treatment group was 344 days, while that in the patients with simple bile drainage or bare metal stent implantation was 193 days (P 鈮，
本文编号：2488157
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