碘-125粒子组织间插植治疗贲门癌的远期疗效

　　镇江359医院

　　张继军  梁彦  高翔 程晓斌 莫晓潮镇江市第四人民医院胸外科张继军

　　【摘要】 目的 探讨贲门癌根治术中组织间插植125I粒子治疗贲门癌的临床价值。方法 对118例贲门癌患者施行根治性手术，其中根治性手术加125I粒子插植组（A组）57例，单纯根治性手术组（B组）61例。对两组患者的3年p5年生存率，以及术后并发症的发生率和病死率进行对照分析。结果 根治性手术加125I插植组3年p5年生存率分别为59.6%p49.1%,明显高于单纯根治性手术组的41.0%p31.1%,两组比较差异有显著性意义（x2=4.072、P<0.05,x2=3.939、P<0.05）。根治性手术加125I粒子插植组术后并发症的发生率和病死率分别为8.8%p1.8%,单纯根治性手术组分别为6.6%p3.3%,两组比较差异无显著性意义（x2=0.111、P>0.05,x2=0.333、P>0.05）。结论 贲门癌根治术中组织间插植125I粒子治疗贲门癌可明显提高远期疗效，与单纯根治性手术相比并不增加术后并发症的发生率和病死率，是一种安全p有效的手术方法。

　　【关键词】贲门肿瘤；外科手术；生存率；125I粒子

　　Longterm therapeutic effects of radical resection plus interstitial radiactive 125I seeds implantation for treatment of cancer of the cardia  ZHANG Ji-jun*，LIANG Yan,GAO Xiang,CHENG Xiao-bin,MO Xiao-chao. Department of Thoracic Surgery ,359 Hospital of PL A , Zhenjiang 212001,China

　　【Abstract】 Objective To evaluate interstitial radiactive 125I seeds implantation for treatment of cancer of the cardia. Methods One hundred and eighteen patients with cancer of the cardia underwent radical resection .Of them, 57 were treated using radical resection plus interstitial radiactive 125I seeds implantation (A group), and 61 were treated using radical resection(B group). The 3-year and 5-year survival rate, and the postoperative complication rate and mortality rate were followed up and compared in the two groups.Results The 3-year and 5-year survial rate of the A group were 59.6% and 49.1%, of  the B group were 41.0% and 31.1%, respectively, and the difference was statistically significant (x2=4.072、P<0.05,x2=3.939、P<0.05). The postoperative complication rate and mortality rate of the A group were 8.8% and 1.8%,of the B group were 6.6% and 3.3%, respectively , and the difference was not statistically significant (x2=0.111、P>0.05,x2=0.333、P>0.05).Conclusions To improve longterm therapeutic effects, radical resection plus interstitial radiactive 125I seeds implantation should be recommended. It is a safe , effective method in the surgical treatment of cancer of the cardia.

　　【Key words】Gastric cardiac neoplasms; Surgical procedures, operative; survival rate ; 125I seeds.

　　作者单位：212001 镇江解放军第三五九医院胸外科（张继军、梁彦、高翔、程晓斌、莫晓潮）

　　通信作者：张继军（Email: zhangjijun359@sina.com）