摘要
目的观察放射性^(125)I粒子植入治疗转移性肝癌的临床疗效及并发症。方法回顾性收集应用^(125)I粒子植入治疗的22例转移性肝癌患者资料,所有患者术前应用治疗计划系统(TPS)制定植入计划,根据TPS计划在CT引导下行肝脏病灶^(125)I粒子植入术,术后行CT检查,将CT图像的DICOM格式图片传送到TPS系统,并进行术后剂量验证。分别于术后1、3、6、9、12个月行CT复查,进行临床疗效及并发症评价。结果 22例患者病灶总数为27个,中位肿瘤最长径3.4 cm(1.0~7.4 cm),病灶植入粒子数4~87颗,粒子活度1.85×107~2.96×107Bq(0.5~0.8 m Ci)。术后1个月,CR 11例,PR 6例,SD 5例,PD 5例,局控率(CR+PR+SD)为81.5%。术后3、6、9、12个月局控率分别为78.9%、76.9%、77.8%、66.7%。中位随访时间6个月(1~14个月),生存13例,死亡9例,中位生存时间12个月。粒子植入术后疼痛缓解率91.7%。术中出血7例(31.8%),恶心/呕吐3例(13.6%),术后发热1例(4.5%),粒子移位2例(9.1%)。结论 ^(125)I粒子植入术治疗转移性肝癌疗效确切,并发症少,是治疗肝脏恶性肿瘤的有效方法之一。
Objective To evaluate the efficacy and complications of CT-guided permanent ^125I seed interstitial brachytherapy in the treatment of metastatic hepatic carcinoma. Methods A total of 22 patients with metastatic hepatic carcinoma were enrolled. A treatment plan was made for each patient using a computerized treatment planning system（ TPS） to determine the dose of radioactive seeds implanted and the site. With CT guidance,^125I seeds were placed into the metastatic sites in the liver. After operation,CT scan was performed to verify the position and intensity of ^125I seeds. CT scan was performed 1 month,3,6,9 and 12 months after operation to evaluate the local control rate of tumor and complications. Results Altogether 27 liver lesions were included in this study. The median longest diameter was 3. 4 cm（ 1. 0-7. 4 cm）. The number of ^125I seeds was 4-87. The activity was 1. 85 × 10^7-2. 96 × 10^7Bq（ 0. 5-0. 8mCi）. One month after operation,11 patients gained complete remission（ CR）,6 partial remission（ PR）,5 stable disease（ SD） and 5 progression of disease（ PD）. The local tumor control rate 1 month,3,6,9 and 12 months after operation was 81. 5%,78. 9%,76. 9%,77. 8% and 66. 7%,respectively. During the follow-up of 1-14 months（ median 6 months）,13 patients survived and 9 died. The median survival time for all patients was 12 months. The rate of pain relief was 91. 7%. Minor complications were bleeding [31. 8%（ 7 /22） ],nsusea / vomiting [13. 6%（ 3 /22） ],fever[4. 5%（ 1 /22） ] and seed displacement [9. 1%（ 2 /22） ]. Conclusion CT-guided125 I seed brachytherapy is a safe and effective treatment for metastatic hepatic carcinoma with fewcomplications.
出处
《山东大学学报（医学版）》
CAS
北大核心
2016年第12期53-57,共5页
Journal of Shandong University:Health Sciences
基金
国家自然科学基金(81272351)
关键词
^125I粒子
肝脏肿瘤
局控率
并发症
^125I seed
Liver malignancies
Local control rate
Complications
