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Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,2020/10/18,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,2020/10/18,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,2020/10/18,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,2020/10/18,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,2020/10/18,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,2020/10/18,Slide,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,2020/10/18,Slide,*,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,Primary Clinical Study of CT-guided Iodine-125 Seed Implantation Therapy in Patients with Advanced Pancreatic Cancer,2020/10/18,1,Brachytherapy,1898,年居里夫人发现镭,1905,年即进行了第,1,例镭针插管治疗,1930,年,Paterson,及,Parker,建立了曼切斯特（,Manchester,）系统,1935,年小居里夫妇发现了人工放射性同位素,80,年代中期，现代近距离治疗迅速发展,2020/10/18,2,生物学优势（外放疗相比）,肿瘤局部治疗的持续时间长,放射治疗的剂量较低,对周围正常组织的损伤小,对肿瘤细胞的杀伤力强,2020/10/18,3,Implant radioactive seeds into tumors,Emit contin,ue,ous low energy,rays,Injury of tissues and cells,Cell death and mutation,lead,ing,to cancer,Interact with biomacromolecule,2020/10/18,4,Animal experiment,Clinical research,2020/10/18,5,Human pancreatic cancer Sw1990 cell,BABL/c was inoculated into the dorsal side of right lower,extremit,y,inguinal region of nude mice,Passaged,for 3 tims,subcutaneously,initiate the experiments,after tumor formation,was stablized,Experimental design,2020/10/18,6,Subcutaneous pancreatic cancer xenograft in nude mice,Seed implantation group,C,ontrol,group,Experimental method,2020/10/18,7,Change,of xenograft volume in nude mice,2020/10/18,8,Comparison of tumor inhibition rate,2020/10/18,9,2020/10/18,10,Obvious liquefaction necrosis can be seen in the centeral area of Experimental group tumor,there are sparse cells aroud the necrosis area,(,100,),HE,staining,There is no or little necrosis area in center of control group tumor,there are multiple,tumor cells,(,100,),2020/10/18,11,Experimental group positive TK1 staining cells are exiguous,（,200,）,Control group positive TK1 staining cells are abundent,（,200,）,HE,staining,2020/10/18,12,2020/10/18,13,碘,-125,放射粒子组织间植入治疗属放射治疗，,对周围正常器官组织无明显放射损伤,裸鼠移植瘤组织植入碘,-125,粒子后，实验组心、,肺、肝、肾、脾脏外观大致正常，病理检查未,见明显放射性炎症表现,Preliminary result,2020/10/18,14,ZM,.,Wang,MD,Shanghai Ruijin Hospital,Introduction,Pancreatic cancer is a devastating disease,and the prognosis remains poor,Few patients are eligible for curative surgical,resection,Alternative therapeutic options are in demand,2020/10/18,15,Traditional therapy vs.External irradiation therapy,vs.percutaneous seed implantation,ZM,.,Wang,MD,Shanghai Ruijin Hospital,2020/10/18,16,External irradiation,therapy was regarded as insensitive to pancreatic cancer and associated with more systemic side effects,Radioactive iodine-125 seed implantation has minimal surgical trauma and few complications,The most commonly used isotope is iodine-125,125,I placement was routinely used at our institution for recurrent tumors at various sites,The aim of this study was to test its feasibility for pancreatic lesions,Current Controversies,2020/10/18,17,11th IO 2010,May,23,Methods and materials,Patient population,December 2004 to August 2007,31 consecutive patients were included in this prospective,nonrandomized study,Patients were diagnosed by CT or MRI with histological confirmation of the diagnosis by FNA,All patients enrolled displayed contraindications to surgery or had rejected surgical treatment due to personal reasons,2020/10/18,18,ZM,.,Wang,MD,Shanghai Ruijin Hospital,Methods and materials,The total volume of each tumor was calculated with the,treatment planning system(TPS)before implantation,The expected number of implanted seed was calculated,according to the modified level formula,Patients were kept in our radiooncology/interventional,ward with an usual stay of 4 full days,2020/10/18,19,Methods and materials,Clinical benefit response was derived from measurement of pain,functional impairment and weight loss,Patients were examined by CT after the operation,Response rate was defined as the sum of CR and PR,Local tumor control was defined as the absence of tumor progression(SD+PR+CR),2020/10/18,20,Methods and materials,10 patients received concurrent chemotherapy with arterial infusion of gemcitabin and 5-fluorouracil(5-Fu),Chemotherapy was initiated one week after and repeated up to four cycles,Follow-up visits at 1 month,3 month,and every 3 mon
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