摘要
目的探讨经肝动脉超选择性灌注32P-玻璃微球联合化疗栓塞治疗肝癌的方法、疗效、影响因素和吸收剂量估算方法。方法采用经肝动脉超选择性段性挤压式栓塞及半肝栓塞的方法灌注32P-玻璃微球、超液化碘油和吡柔比星(THP)混悬液治疗30例肝癌患者,术后行β轫致辐射显像,结合分区模型,估算肿瘤、非瘤肝组织和肺组织的吸收剂量。采用不含32P-玻璃微球的混悬液化疗栓塞治疗26例肝癌患者作为对照组。结果实验组反应率(70.0%)明显高于对照组(42.3%)(χ2=4.362,P<0.05);实验组6、12、18个月生存率分别为100.00%、76.67%、43.33%,对照组为92.31%、61.54%、19.23%。估算肿瘤组织的平均吸收剂量(130.34±54.53)Gy,非瘤肝组织为(34.73±13.41)Gy,肺组织2.1～16.3Gy。肿瘤吸收剂量≥120Gy的反应率(100%)高于剂量<120Gy的反应率(47.1%)(χ2=9.832,P<0.01)。结论经肝动脉采用超选择性段性挤压式栓塞及半肝栓塞的方法灌注32P-玻璃微球联合化疗栓塞治疗肝癌是1种安全有效的方法。术后β轫致辐射显像结合分区模型估算肿瘤组织和非瘤肝组织的吸收剂量,为剂量学研究提供了1个可行的方法。
Objective To study the therapy method, effect and radiation doses estimation in clinical research of intra-arterial radioembolization with ^32 P-glass microspheres combined with chemoembolization for treatment of liver cancer. Methods Thirty patients with liver cancer were treated by infusion of suspension of ^32 P-glass microspheres mixed with lipiodol-ultrafluid（5 -20 ml） and THP（ 10 mg） via hepatic-artery with method of segmental and half-hepatic embolization. β bremsstrahung imaging was performed after treatment, combined with partition modal, radiation doses in tumor, normal liver tissue and lung tissue were estimated respectively. Twenty-six patients with liver cancer were treated by chemoembolization with lipiodol-ultrafluid in control group. Results The response rate of treatment group is 70.0%, higher than 42. 3% of control group （ P 〈 0. 05 ）. The survival rate of 6, 12, 18 months was 100. 00%, 76. 67%, 43.33% in treatment group, and 92.31%, 61.54%, 19. 23% in control group respectively. The mean estimated radiation doses in tumors were （ 130. 34± 54. 53） Gy, （34. 73 ± 13.41 ） Gy in normal liver tissue, and ranged from 2. 1 to 16. 3 Gy in lung tissue. The rate of response was 100% in 13 patients who received radiation doses of 〉t 120 Gy to tumor, and 47.1% in 17 patients who received radiation doses of 〈 120 Gy to tumor （P 〈 0. 01 ）. Conclusions Super selective intra-arterial radioembolization with ^32P-glass microspheres combined with chemoembolization is a effective and safe treatment of liver cancer. Estimation of radiation doses in tumor, normal liver tissue and lung tissue respectively with β bremsstrahung imaging and partition modal is a practical method for radiation dose research.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2005年第10期1068-1072,共5页
Chinese Journal of Radiology
基金
天津市自然科学基金资助项目(003607111)
