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目的:观察高强度聚焦超声(HIFU)与125I放射性粒子植入治疗中晚期胰腺癌的临床疗效和安全性。方法:124例中晚期胰腺癌患者随机分为A组(29例)、B组(33例)、C组(32例)和D组(30例)。A组给予单纯化疗,B组采用HIFU治疗联合化疗,C组采用125I放射性粒子植入治疗联合化疗,D组采用125I放射性粒子植入治疗+HIFU治疗+化疗。比较各组患者临床受益情况、疗效、生存时间和不良反应。结果:A组、B组、C组和D组的临床受益率分别为27.59%,84.85%,78.13%和83.33%,联合治疗(B组、C组和D组)明显优于单纯化疗的A组(P<0.05),B组、C组和D组间差异无统计学意义(P>0.05);各组总有效率分别为17.24%,72.73%,43.75%和93.33%,联合治疗(B组、C组和D组)明显优于单纯化疗的A组(P<0.05),且D组明显优于B组,B组明显优于C组(P<0.05);A、B、C、D组的肿瘤体积缩小率分别为14.7%,54.3%,31.8%和65.5%,组间差异具统计学意义(P<0.05)。各组中位生存期比较,联合治疗(B组、C组和D组)生存率明显优于单纯化疗的A组(P<0.05),且D组明显优于B组,B组明显优于C组(P<0.05);各组不良反应无显著差别(P>0.05)。结论:HIFU、125I放射性粒子植入和化疗均为治疗中晚期胰腺癌可选择的有效手段,联合治疗较单纯治疗更佳;HIFU和125I放射性粒子植入联合治疗并辅助化疗的疗效明显,是一种安全、有效的治疗方法。
Objective: To observe the clinical efficacy and safety of high intensity focused ultrasound (HIFU) and 125I radioactive seed implantation in the treatment of advanced pancreatic cancer. Methods: 124 patients with advanced pancreatic cancer were randomly divided into group A (n = 29), group B (n = 33), group C (n = 32) and group D (n = 30). Group A received chemotherapy alone, Group B received HIFU combined with chemotherapy, Group C received 125I radioactive seed implantation combined with chemotherapy, and Group D received 125I radioactive seed implantation plus HIFU plus chemotherapy. The clinical benefit, efficacy, survival time and adverse reactions of each group were compared. Results: The clinical benefit rates of group A, group B, group C and group D were 27.59%, 84.85%, 78.13% and 83.33% respectively. Combination therapy (group B, group C and group D) was significantly better than that of group A (P <0.05). There was no significant difference between group B, group C and group D (P> 0.05). The total effective rate was 17.24%, 72.73%, 43.75% and 93.33% Group C, group D) were significantly better than group A (P <0.05), and group D was better than group B. Group B was significantly better than group C (P <0.05) The tumor volume shrinkage rates in group D were 14.7%, 54.3%, 31.8% and 65.5%, respectively. The difference between groups was statistically significant (P <0.05). The median survival time in each group was significantly better than that in chemotherapy alone (P <0.05), and the combination group (group B, group C and group D) was significantly better than group B Group C (P <0.05); There was no significant difference in each group (P> 0.05). CONCLUSION: HIFU and 125I radioactive seed implantation and chemotherapy are both effective and effective methods for the treatment of advanced pancreatic cancer. Combination therapy is better than simple therapy. HIFU and 125I radioactive seed implantation combined with adjuvant chemotherapy have obvious curative effect A safe and effective treatment.