论文部分内容阅读
目的探讨晚期胰腺癌的新疗法。方法29例晚期胰腺癌(12例伴有肝转移)病人被随机分成两组。A组(11例)行胆肠和(或)胃肠转流术加术后全身化疗。B组(18例)行胆肠和(或)胃肠转流术加胰周血管结扎联合动脉灌注区域化疗。对比观察两组病人临床症状缓解情况,B超、CT监测肿瘤体积变化,生存期,及血清CEA水平变化。结果B组大部分病人临床症状得到明显缓解;B超、CT监测显示B组肿瘤体积明显缩小;治疗有效率B组为67.7%,A组为18.2%(P<0.01);生存期B组为(12.5±1.2)个月,A组为(4.8±0.6)个月(P<0.01);两组间有明显差异。血清CEA下降率B组为60%,A组为54%(P>0.05),两组间无明显差异。结论对晚期胰腺癌及肝脏转移病人胰周血管结扎联合动脉灌注区域化疗是一种安全有效的治疗手段,它能减轻临床症状、延缓肿瘤生长速度、延长病人生存期。
Objective To explore new therapies for advanced pancreatic cancer. Methods Twenty-nine patients with advanced pancreatic cancer (12 with liver metastases) were randomized into two groups. Group A (n = 11) underwent choledochojejunostomy and / or gastrointestinal bypass plus postoperative systemic chemotherapy. Group B (n = 18) underwent choledochojejunostomy and / or gastrointestinal bypass combined with peritumoral ligation and arterial infusion chemotherapy. The clinical symptoms of two groups were compared. The changes of tumor volume, survival time and serum CEA level were monitored by B ultrasound and CT. Results The clinical symptoms of most patients in group B were relieved significantly. The B-ultrasound and CT findings showed that the volume of tumor in group B was significantly reduced. The effective rate of treatment was 67.7% in group B and 18.2% in group A (P <0.01) (12.5 ± 1.2) months in group A and (4.8 ± 0.6) months in group A (P <0.01). There was a significant difference between the two groups. Serum CEA decreased rate of 60% in group B, 54% in group A (P> 0.05), no significant difference between the two groups. Conclusion It is a safe and effective treatment for peripancreatic vascular ligation and arterial perfusion chemotherapy in patients with advanced pancreatic cancer and liver metastasis. It can reduce clinical symptoms, delay tumor growth and extend patient survival.