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病例报告: 序列性PTCD和胆汁种子支架结合针对性免疫疗法治疗恶性阻塞性黄的晚期胰腺癌:多学科方法

Weijun Li¹, Guoyang Sun², Rui Zhu³

¹Department of Emergency Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Frontiers in oncology

|September 4, 2025

概括

可有效治疗晚期胰腺癌引起的恶性阻塞性黄. 一种多学科的方法, 结合皮肤透过肝胆管排水, 种子支架和向免疫疗法, 提供持续的胆道通透性和改善生活质量.

科学领域:

癌症学
胃肠病学
干预性放射学

背景情况:

晚期胰腺癌的恶性阻塞性黄 (MOJ) 是一个严重的临床挑战,预后不佳.
瘤压缩或入侵胆道需要有效的治疗策略来缓解阻塞并改善患者的治疗结果.

研究的目的:

通过综合多学科方法管理的晚期胰腺头部癌症的案例研究.
在不能接受标准化疗的患者中,评估连续干预措施的有效性,包括皮肤间胆管疏通 (PTCD),胆管支架和向免疫治疗.

主要方法:

使用塑料支架进行的初始内逆向胆瘤造影 (ERCP) 随后由于支架封闭而出现紧急PTCD.
用金属支架和-125种子植入来控制胆道阻塞.
患者在对gemcitabine + nab- paclitaxel (AG) 不耐受后接受了断层疗法 (TOMO) 和个性化治疗方案.

主要成果:

在七天内,PTCD和种子支架迅速将总 bilirubin (TBIL) 从116. 9降至45. 6μmol/ L.
个性化治疗方案导致CA19-9减少78%和持续的胆道通透性.
一年后的随访显示TBIL正常化 (18. 2μmol/ L) 和直接胆红素 (DBIL) (9. 8μmol/ L),卡诺夫斯基分数为90,表明生活质量良好.

结论:

序列性PTCD,种子支架和向免疫疗法为治疗晚期胰腺癌提供了有效的策略.
这种多学科的方法可以实现持续的胆管减压,控制瘤,并保持患者的生活质量.
这一案例为治疗胰腺癌引起的胆道阻塞的复杂病例提供了一个实用模型.

关键词:

恶性阻塞性黄多学科战略胰腺癌通过皮肤通过肝脏的胆管排水针对性免疫疗法

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