摘要
目的评价CT引导下125Ⅰ粒子组织间植入治疗盆腔难治性恶性肿瘤的临床疗效,探讨粒子植入技术。方法23例盆腔恶性肿瘤,均为术后复发接受化疗和(或)根治量放疗肿瘤仍进展患者,瘤体最大径3.5～7.0 cm,平均4.5 cm。粒子植入术前1～3 d行模拟CT扫描,采用治疗计划系统(TPS)制定粒子植入计划,根据处方剂量求出术中所需125Ⅰ粒子的总活度并算出治疗粒子数量。在CT引导下经皮穿刺植入125Ⅰ粒子。其中6例患者粒子植入前或后接受髂内动脉灌注化疗。结果单个瘤体内首次植入粒子数为9～75粒,平均27粒。6例接受髂内动脉灌注化疗共14个疗程。粒子植入术后72 h～4周,下肢疼痛和(或)肛门、会阴周围疼痛坠胀不适,完全缓解5例,部分缓解11例,有效率69.6%(16/23)。术后随访2～34个月,中位随访21个月,部分缓解(PR)18例;无变化(SD)4例;进展(PD)1例,总有效率78.3%(18/23)。死亡3例,存活20例,最长生存时间34个月。结论CT引导下125Ⅰ粒子植入对盆腔难治性恶性肿瘤安全、有效。
Objective To evaluate the efficacy of percutaneous CT guided interstitial ^125I seeds implantation treatment for refractory pelvic malignant tumors and discuss the procedure of technique. Methods Twenty-three patients with refractory pelvic malignant tumors（25 lesions, diameter 3.5-7.0 cm, mean 4.5 cm） showing failure response to full chemotherapy and/or radical radiotherapy after tumors resection were undergone percutaneous CT guided intratumoral ^125I seed implantation. Treatment plan system（TPS）was used to design the distribution and number of ^125I seeds according to matched peripheral dose （MPD）1-3 days before the procedure. Of which 6 cases received combined internal iliac arterial infusion chemotherapy before or after the ^125I seed implantation procedure. Results 9 - 75（mean 27）^125I seeds were implanted into a single tumor at first time including 6 patients with intraarterial chemotherapy for 14 cycles （mean 2.3 cycles）, showed relief of clinical pain symptoms in 16 of 23 cases, 72 h - 4 w after the seeds implantation; with the an effective rate of 69.6%. Follow up for 2-34 months （median, 21 months）, CT or MRI performed 2 months after the seeds implantation showed no CR, but PR in 18 cases, SD in 4 cases, and PD in 1 case, with overall response rate of 78% （18/23）, and no serious complication. In addition, 20 cases survived, with the longest one of 34 months and the other 3 died. Conclusions Intratumoral ^125I seeds implantation under CT guidance for pelvic refractory malignant tumors is safe, minimally invasive, and effective.
出处
《介入放射学杂志》
CSCD
2008年第5期343-345,共3页
Journal of Interventional Radiology
