摘要
目的 探讨不同外科治疗手段在治疗晚期胰腺癌患者中的临床疗效和预后情况.方法 根据纳入标准回顾性分析解放军总医院2009年1月至2013年12月连续223例晚期胰腺癌患者的临床资料,将患者分为粒子组49例,射频组51例,放疗组17例和对照组106例,并对组间一般资料、并发症及随访情况进行统计分析.结果 4组患者一般资料比较差异无统计学意义（P＞0.05）,本组资料中无围手术期死亡患者,粒子组并发症的发生率最高,为43％ （21/49）,但均为ClavienⅡ级并发症.随访终点为2014年3月,随访时间为1～52个月,中位时间为7个月,总体随访率为88.3％（197/223）,其1个月、6个月、1年、2年的生存率分别为95.9％,53.7％,19.1％,7.3％,平均生存（9.6±0.3）个月.其中粒子组1个月、6个月、1年、2年的生存率分别为97.7％,61.9％,27.7％,13.2％,平均生存（12.9±1.1）个月;射频组1个月、6个月、1年、2年的生存率分别为88.9％,54.9％,22.9％,7.6％,平均生存（9.6±0.9）个月;放疗组1个月、6个月、1年、2年的生存率分别为93.7％,56.2％,18.7％,6.2％,平均生存（8.6±1.4）个月;对照组1个月、6个月、1年、2年的生存率分别为97.8％,48.9％,13.8％,5.4％,平均生存（8.5±0.5）个月.分别将粒子组、射频组、放疗组与对照组患者之间的生存曲线进行两两比较,Log-rank检验结果提示粒子组患者生存率和平均生存时间均高于对照组（P＜0.05）,而射频组和放疗组与对照组之间生存率差异均无统计学意义（均P＞0.05）.结论 晚期胰腺癌患者总体预后差,生存时间短,对于此类患者,放射性粒子植入术能有效延长患者的生存时间,但也增加了术后并发症的发生率,而射频消融术和术中放疗术在本组资料中未能有效延长患者的生存时间.
Objective To explore the clinical efficacies of different surgical strategies for patients with advanced pancreatic carinoma.Methods Retrospective analyses were conducted for the clinical data of 223 advanced pancreatic carinoma patients between January 2009 and December 2013 according to the inclusion criteria.And,according to different surgical strategies,they were divided into seed group （n =49）,radio frequency ablation group （n =51）,radiotherapy group （n =17） and control group （n =106）.The general data,postoperative complications and follow-up profiles between 4 groups were statistically analyzed.Results The general profiles between four groups were not statistically significant （P 〉 0.05）.There was no mortality.The postoperative complication rate was the highest at 43% （21/49） in seed group.However all complications were of Clavien grade Ⅱ.The follow-up endpoint was until March 2014.The median follow-up period was 7 （1-52） months.The overall follow-up rate was 88.3% （197/223）.And their survival rates of one month,half a year,one year and two years were 95.9%,53.7%,19.1% and 7.3% respectively.The average survival time was （9.6 ± 0.3） months.In seed group,the rates were 97.7%,61.9%,27.7% and 13.2% respectively.The average survival time was （12.9 ± 1.1） months.In radio frequency ablation group,the rates 88.9%,54.9%,22.9% and 7.6% respectively.The average survival time was （9.6 ±0.9） months.In radiotherapy group,the rates were 93.7%,56.2%,18.7% and 6.2% respectively.The average survival time was （8.6 ± 1.4） months.In control group,the rates were 97.8%,48.9%,13.8% and 5.4% respectively.The average survival time was （8.5 ±0.5） months.The survival curves of seed,radio frequency ablation and radiotherapy groups were compared separately with that of control group.The Log-rank test results suggested that the survival rate and mean survival time of seed group were higher than those of control group （P 〈 0.05）.However the radio frequency ablation and radiotherapy groups had no significant difference with control group.Conclusions The advanced pancreatic carinoma patients have poor outcomes with a short survival time.The intraoperative implantation of seeds is effective for advanced pancreatic cancer patients,but it also has a high incidence of postoperative complications.Radio frequency ablation and intraoperative radiotherapy fail to effectively prolong the patient survival time.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2015年第2期89-92,共4页
National Medical Journal of China
关键词
胰腺肿瘤
粒子
导管消融术
放射疗法
Pancreatic neoplasms
Particle
Catheter ablation
Radiotherapy
