Study On The Dosage Of Iodine-125seeds Implantation Combined With Gemcitabine Chemotherapy In Treatment Of Pancreaticcancer

ObjectiveTo investigate the optimal dosage of Iodine-125 seeds implantation combined with gemcitabine chemotherapy,and to provide corresponding reference for future clinical treatment.MethodsBy collecting relevant data of 55 patients with intermediate and advanced pancreatic cancer who could not be surgically resected from December 2017 to July 2019,China-Japan Union Hospital of Jilin University,all patients were confirmed pancreatic cancer by pathological examination.There were 33 males and 22 females,aged 39~79 years,with an average age of 59.7 ± 9.82 years.According to the TNM standard of pancreatic cancer,36 cases were stage III,and 19 cases were stage IV.Tumors in the head of the pancreatic were 22 cases,tumors in the body of the pancreatic were 24 cases,and tumors in the tail of the pancreatic were 9 cases.All patients were randomly divided into two groups,the observation group treated by Iodine-125 seeds implantation combined with gemcitabine chemotherapy,the control group treated by Iodine-125 seeds implantation.The observation group consisted of 30 patients,of which 12 patients were divided into group A with gemcitabine chemotherapy at a regular dosage after surgery,11 patients were treated with gemcitabine chemotherapy after surgery at 2/3 of the regular dosage and divided into group B,and 7 patients were divided into group C with gemcitabine chemotherapy at 1/3 of the regular dosage after surgery.The control group have 30 patients.All patients started to follow up after surgery or after chemotherapy,to observe and record the tumor treatment effect,clinical benefit response,toxic reaction and the completion of control group.ResultsThe effective rate(CR + PR)of the observation group was 50%,and the effective rate(CR + PR)of the control group was 24%,there is significant difference between the two groups.The Clinical benefit response of the observation group was 60%,and The Clinical benefit response of the control group was 32%,there is significant difference between the two groups.The incidence of leukopenia and nausea in the observation group were 40.0% and 33.3%,and the control group was 12.0% and 4.0%,there were significant difference between the two groups.The incidences of platelet reduction,hemoglobin reduction,and vomiting in the observation group were 30.0% and 20.0%,16.7%,the control group was 12.0%,8.0%,4.0%,there were no significant difference between the two groups.In terms of tolerance,4 patients in group A completed all chemotherapy courses(4/12,33.3%),9 patients in group B completed(9/11,81.8%),and 6 patients in group C completed(6 / 7,85.7%),the tolerance of patients in the B and C groups is almost equal,which is significantly higher than that of the A group.There is significant difference between the A and B group(P value is 0.019).There is no significant difference between the B and C group(P value is 0.828).There is no significant difference between the A and C group(P value is 0.027).ConclusionsCompared with the Iodine-125 seeds implantation,Iodine-125 seeds implantation combined with gemcitabine chemotherapy had an affirmative clinical efficacy,And got those following conclusions.1.Significant improvement in tumor treatment effect and clinical benefit response.2.The incidence of leukopenia and nausea are increasing.3.When the dosage of gemcitabine is 2/3 of the regular dosage,the patient's chemotherapy tolerance is significantly improved.When the dose is further reduced,the tolerance do not change significantly.4.Under the premise that the patient can tolerate chemotherapy,in order to obtain the best tumor and clinical benefit,and to reduce the incidence of side effects of chemotherapy as much as possible,the dosage of gemcitabine chemotherapy for pancreatic cancer after the Iodine-125 seeds implantation is recommended as 2/3 of the regular dosage.