Efficacy Analysis Of Ultrasound-guided Radioactive Particle Implantation In The Treatment Of Pain Associated With Unresectable Pancreatic Cancer

Objective:To investigate the clinical efficacy,safety and feasibility of ultrasound-guided radioactive particle implantation in the treatment of pain associated with unresectable pancreatic cancer.Method:The clinical and follow-up data of 160 patients with pancreatic cancer who received ultrasound-guided percutaneous radioactive particle implantation as the primary treatment in China-Japan Friendship Hospital of Jilin University from January 2008 to July 2019 were retrospectively analyzed.Inclusion criteria: All cases underwent fine needle aspiration pathology and were diagnosed as pancreatic ductal adenocarcinoma;In newly diagnosed cases,anti-tumor therapy was not received after definite diagnosis.All patients and their family members signed the informed consent for surgical treatment,with complete clinical data,and were followed up.There were 109 males and 51 females with an average age of 61.75±9.85(32-85)years.10 cases of tumor TNM staging of Ⅰperiod respectively,Ⅱ period 18 cases,Ⅲ period in 95 cases,37 casesⅣ period.Of the 160 patients,115 had epigastric and/or back pain,which was graded by visual analogue scale(VAS).Forty-five patients with grade 0 had no pain.51 cases of grade I,the pain was tolerable,did not affect sleep,normal life;Thirty-nine patients with grade II were found to have obvious pain,intolerance,disturbed sleep and required to take analgesics.Class III 25 patients had severe,intolerable pain,severely disturbed sleep,and needed analgesics.Among the 115 cases of pain,56 cases of abdominal pain with lumbar and back pain;33 patients with abdominal pain;There were 26 cases of low back pain.Results:Among the 115 cases with preoperative abdominal and/or lumbar and back pain,104 cases of postoperative pain were relieved to varying degrees,and the analgesic rate was 90.43%(104/115).Of the 51 patients with grade I pain,49 had complete pain relief and 2 had no effect.Of the39 grade II pain cases,29 were completely relieved,6 were downgraded to grade I,and 4 were ineffective.Of the 25 grade III patients,11 had complete pain relief,4 were downgraded to grade II,5 were downgraded to grade I,and 5 were ineffective.Conclusions:1.Radioactive particle implantation in the treatment of pancreatic cancer can effectively relieve patients’ intractable pain,improve the quality of life of patients,and also have the possibility of local control of tumor lesions and inhibition of tumor growth.It is an effective minimally invasive method to treat advanced pancreatic cancer that is difficult to respectable,recurrent pancreatic cancer that cannot be treated after surgery and pancreatic cancer that has metastatic.At the same time,it also has the advantage of easy to protect after surgery.2.Ultrasonic guidance has the advantages of real-time monitoring,easy operation,no radiation,and accurate positioning,excellent performance and price ratio.The guiding role in radioactive particle implantation has a broader prospect.3.Radioactive particle implantation under ultrasound guidance is a safe,feasible,less complications and has a broad development prospect for the treatment of advanced pancreatic cancer.