| Pancreatic cancer is one of the common malignant tumors in digestive system with high level of viciousness, and its incidence has significantly increased in recent decades. Because the pancreas is located in retroperitoneal, lack early symptoms, the finding cases are almost in advanced stage; with rich blood supply and around with many very important organizations and structurehas, such as duodenum, portal vein, common bile duct, celiac artery and its branches, superior mesenteric artery, abdominal main artery and so on; At the same time, the pancreas is the important exocrine and endocrine organ in human: besides the main role in digestion and absorption of food, pancreatic juice also can digeste and destroy own organizations, leaded to serious result, the insulin and other endocrine liquids play a crucial role in the regulation of blood glucose and regulating body metabolism. Combined with so many factors above, the treatment of pancreatic cancer is difficult: low surgical resection rate, more postoperative complications, and the survival rate is low. Any more, For patients with advanced pancreatic cancer, often have intractable pain, bile duct and duodenal obstruction, followed with many severe complications such as obstructive jaundice, high fever, intestinal obstruction. the patients have very low quality of life. Therefore, how to prolong such patients'survival time and improve their quality of life has always been a goal in medical workers. 125I radioactive particles maximum the role of anti-pancreatic cancer cells, effective control the tumor growth through continuous release low-energyγ-rays. at the same time,this method is relatively simple, safe and low side effects, it playing an increasingly important role as a new method in pancreatic cancer treatment, and accepted by doctors at home and abroad. This article observed the survival time, pain relief and other factors of 52 cases of pancreatic cancer patients after treated with 125I radioactive seed implantation.Objective: To observe and statistics the survival time and pain relief of 52 cases of pancreatic cancer patients in different stages treated with 125I radioactive seed implantation, then compared with the datum gained from the same diagnose patients which treated with traditional methods.the objiective is to observe the effects when treated with 125I radioactive seed implantation, and to explore the feasibility and effectiveness of the treatment of 125I radioactive seed implantation in pancreatic cancer in different stages. Providing reference for advanced pancreatic cancer treatment.Methods: 52 cases of pancreatic cancer patients using 125I radioactive seed implantation therapy in China-Japan unin Hospital of Jilin University from April 2004 to March 2008, 36 cases of male, 16 cases of female, age from 36 to 85 years old, the average is 59.52 years . 36 cases of pancreatic tumor that located in the head with the clinical manifestations of obstructive jaundice, among which 25 cases have abdominal and back pain. 14 cases located in the body and tail of the pancreas, among which 9 cases manifested as abdominal and back pain , two cases have abdominal mass.There are 1 case of stageⅡA, five cases of stageⅡB, 28 cases of stageⅢ, 18 cases of stageⅥaccording to the International UICC (2002, 6th edition) TNM staging of pancreatic cancer methods.34 cases were given cholecystojejunostomy+125I radioactive particles implantation, 3 cases were given laparotomy+125I radioactive seeds implantation, 13 cases were given 125I radioactive seeds implantation through the skin puncture, 2 cases were given 125I radioactive seeds implantation and biliary stent through the skin puncture. We observed their survival time, pain relief and other related indicators after the treatment. Then have our patients'average survival time compared with the datum contain from Chinese Anti-cancer Association of Professional Committee.Results: the survival time is 18.2 months in stageⅡB, 13.8 months in stageⅢand 5.2 months in stageⅥ.the totle mean survival time is 11.3 months. among which, the survival time are 2.5 to 11.5 months in 18 cases of stageⅥpatients, there are still 2 cases are living in July 2008. After one week, in 34 cases of patients with pain, 17 cases of obvious effective, 10 cases of effective and 7 cases of ineffective according to the pain relief criteria of WHO cancer institute. And the average relief time is 3.3d in 14 cases of stageⅢpatients, 2.9d in 12 cases of stageⅥpatients. All 36 cases patients with obstructive Jaundic,the Jaundic gradually diminished within one week. There are complications such as ascites, abdominal distension, stomach paralysis and others carried out in the early years.among them, 7 cases of patients with more substantial ascites, with the volume ranged from 200ml-2000ml/d, and the ascites disappeared in 5 days to 4 weeks after given full nutritional support and somatostatin in treatment .5 cases of patients with abdominal distension, nausea, vomiting, anorexia and other gastrointestinal symptoms and 1 case of patient with gastroparesis, after given the gastrointestinal motility medicine, the gastrointestinal tract mucosa protection agents and nutritional support, all the symptoms turn to better. 1 case of patient had one particle migrating to the liver, through a number of follow-up did not there are no radioactive hepatitis, embolism and other poor performance have founded, so, not given special treatment. There were no perioperative deaths, no postoperative pancreatic fistula, hemorrhage, infection and other serious complications.Conclusion: 1. 125I radioactive particles can significantly extend the survival time of stageⅢand stageⅣpancreatic cancer patients. This method is safe and effective, easy to operate, less side effects and less post-operative complications, patients satisfied with it; 2. 125I radioactive particles can significantly to ease the pain of patients with different stages and may play a role in reduce the manifestation of jaundice, etc, thus improving the patients'quality of life. |
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