CAJ | 학술논문

目的探讨经内镜碘-125(125I)粒子置入腔内近距离照射治疗胆管癌的有效性和安全性.方法对65例胆管癌患者采用经内镜逆行胰胆管造影诊疗技术,自制125I粒子施源器,应用各种方式将125I粒子置入胆管腔内照射治疗胆管癌,并用不同更换粒子方法以提高局部照射剂量,术后定期复查胃镜及超声,评价操作可行性、临床有效性、并发症发生率.结果 65例胆管癌患者顺利完成金属支架、单根及双根塑料支架置入,首次125I粒子施源器置入单排59例、双排6例,初次照射平均活度5.775 mCi;3个月后更换125I粒子4例,6个月后更换41例,1年后更换5例,总照射剂量最高达14 mCi.65例患者随访6-35个月,存活时间最长2例为35个月,共更换粒子3次,无严重并发症发生.结论内镜下125I粒子置入腔内持续照射治疗胆管癌明显延长患者生存期,胆道支架及125I粒子施源器可分别随时更换,操作简便、创伤小.
목적 탐토경내경전-125(125I)입자치입강내근거리조사치료담관암적유효성화안전성.방법 대65례담관암환자채용경내경역행이담관조영진료기술,자제125I입자시원기,응용각충방식장125I입자치입담관강내조사치료담관암,병용불동경환입자방법이제고국부조사제량,술후정기복사위경급초성,평개조작가행성、림상유효성、병발증발생솔.결과 65례담관암환자순리완성금속지가、단근급쌍근소료지가치입,수차125I입자시원기치입단배59례、쌍배6례,초차조사평균활도5.775 mCi;3개월후경환125I입자4례,6개월후경환41례,1년후경환5례,총조사제량최고체14 mCi.65례환자수방6-35개월,존활시간최장2례위35개월,공경환입자3차,무엄중병발증발생.결론 내경하125I입자치입강내지속조사치료담관암명현연장환자생존기,담도지가급125I입자시원기가분별수시경환,조작간편、창상소.
Objective To evaluate efficacy and safety of Iodine-125 seeds used in brachytherapy for cholangiocarcinoma.Methods A total of 65 cases of cholangiocarcinoma patients were diagnosed and treated with ERCP.The Iodine-125 seeds were implanted into bile duct cavity by self-made carrier (applicator) in various ways, and Iodine-125 seeds were replaced to improve the local irradiation dose.Follow-up was regularly made through endoscopy and ultrasonography to evaluate feasibility, efficacy and complications.Results Self-expanding metal stents, single or double plastic stents were successfully placed in 65 patients.At first , single row of Iodine-125 seeds were inserted to 59 patients, double row Iodine-125 were inserted to 6 patients , and the average activity of the first irradiation was 5.775 mCi.Iodine-125 were replaced in 4 patients after three months, in 41 patients after six months, in 5 patients after one year.The total dose was up to 14 mCi.In the follow-up of 6-35 months, the longest survival time was 35 months in two patients, where the Iodine-125 seeds were replaced 3 times as a whole and there was no serious complications.Conclusion Iodine-125 brachytherapy on cholangiocarcinoma by ERCP, where biliary stents and Iodine-125 seeds can be replaced at any time , is convenient, less invasive and can obviously prolong survival time.