CAJ | 학술논문

目的　探讨不能手术切除的胆胰恶性肿瘤所致胆道梗阻的腔内放射治疗的入路设置和放射剂量。　方法　对22例胰头癌和胆管癌患者施行腔内放射治疗，放射源为铱192。施源管入路：15例经PTCD（经皮肝穿刺胆管造影引流）途径，在PTCD检查治疗的同时，置入胆道记忆金属扩张支架于肿瘤狭窄处，施源管亦经该途径贯穿肿瘤；6例为剖腹探查肿瘤不能切除时，于直视下将施源管沿肿瘤长轴插入并贯穿肿瘤；1例经胆囊造瘘管置入。腔内放射参数：源外参考点1～2cm，源行长度2～8cm，放射剂量500～1000cGY/次，总剂量：3000～5000cGY。对9例胰头癌肿瘤较大者辅以钴60外放射。　结果　全组22例黄疸均逐渐消退，顽固性腹背部疼痛缓解。3、6、9、12、15、18、21个月生存率分别为82%、73%、65%、47%、38%、27%、22%。　结论　腔内放射治疗胆道恶性梗阻创伤小，操作简单，疗效明显，易被患者接受。对手术禁忌证或肿瘤不能切除的胆胰系统恶性肿瘤是首选治疗方法之一。
목적　탐토불능수술절제적담이악성종류소치담도경조적강내방사치료적입로설치화방사제량。　방법　대22례이두암화담관암환자시행강내방사치료，방사원위의192。시원관입로：15례경PTCD（경피간천자담관조영인류）도경，재PTCD검사치료적동시，치입담도기억금속확장지가우종류협착처，시원관역경해도경관천종류；6례위부복탐사종류불능절제시，우직시하장시원관연종류장축삽입병관천종류；1례경담낭조루관치입。강내방사삼수：원외삼고점1～2cm，원행장도2～8cm，방사제량500～1000cGY/차，총제량：3000～5000cGY。대9례이두암종류교대자보이고60외방사。　결과　전조22례황달균축점소퇴，완고성복배부동통완해。3、6、9、12、15、18、21개월생존솔분별위82%、73%、65%、47%、38%、27%、22%。　결론　강내방사치료담도악성경조창상소，조작간단，료효명현，역피환자접수。대수술금기증혹종류불능절제적담이계통악성종류시수선치료방법지일。
Objective　 To explore the installation and the dosage arrangement of intraluminal radiotherapy for patients with unresectable cholangiopancreatic carcinoma.　 Methods　 21 cases with cholangiopancreatic carcinoma received intraluminal radiotherapy. The radial resource was Ir192. The radioisotope was introduced through PTCD pathway in 15 cases, by exploratory laparotomy in 6 cases, and through the fistula of the gallbladder in 1 case. The radial dose was 500～1000cGY/per session, the total dosage was 3000cGY to 5000cGY. 9 cases of pancreatic head carcinoma received Co60 adjuvant external radial therapy.　 Results　 The jaundice and the obstinate pain in all cases disappeared gradually. The 3,6,9,12,15 and 18 month survival rates were 82%, 73%, 65%, 47%, 38%, 27%, and 22% respectively.　 Conclusion 　Intraluminal radiotherapy has the advantages of less trauma, safe, effectiveness, which was indicated in patients with unresectable pancreatobiliary carcinoma.