摘要
目的评估放射性125I粒子组织间植入治疗多种晚期恶性肿瘤的疗效和副反应。方法患者经局部麻醉后，在影像引导下行125I粒子植入。原发肿瘤边缘植入靶区外放1cm，转移瘤边界以影像学为准。根据治疗计划实施粒子针插植，利用枪式植入器后退式植入粒子。结果植入病例全部成功，无严重并发症。术后复查CT及外周血象，未出现放射损伤及粒子脱落、游走，少数患者出现轻度血红蛋白及血小板的降低，Ⅲ-Ⅳ度白细胞降低发生率为8．1％（3/37）。术后12月随访5例肿瘤完全缓解（CR），11例部分缓解（PR），6例稳定（NC），1例进展（PD）。3例患者恶性肿瘤特异性生长因子（TSGF）多次升高，认为是治疗失败，局部控制率82．6％（19／23），总的有效率为69．6％（16／23）。术前30例疼痛患者中17例疼痛完全缓解，9例部分缓解，4例无变化，有效率86．7％（26／30）。1、3、6个月及1年的生存率分别为100％、94．59％、81．08％和62．16％。结论125I粒子组织间植入治疗晚期恶性肿瘤适应症广，疗效明确，副作用小。由于所选病例分期较晚，未取得理想的生存率。
Objective To evalue recent efficiency and side effects of 125I seed brachytherapy for late - staged malignant tumors. Methods All the patients with residual or recurrent unresectable malignancies were treated with 125I seed implantation under CT scan after they were given a local anesthesia. The seeds were retrogradely placed with a gun applicator according to the previous therapy planning. Results All the patients were implanted succeedly and no severe complications were recorded postoperatively. In all cases, the particles didn＇t fall off or shift. Only minority of patients showed light loss of thrombocyte and hemoglobin. Acute leucocytopenia was seen in 3 patients. A complete response was achieved in 5 patients and a partial response in 11 patients. 6 patients were assessed as having stable disease while 1 patients having progressive disease. In three patients the serum TSGF level was increased significantly,which was supposed to be failure. The local control rate was 82.6% （ 19/23 ） and the total response rate was 69.6% （ 16/23 ）. Thirty patients suffered the pain before treated with125 I. Postoperatively a complete pain relief was achieved in 17 patients,a partial relief in 9 patients and no change in 4 patients. The response rate was 86. 7% （26/30）. The survival rate of 1,3,6 month and 1 year were 100% , 94.59% ,81.08% and 62.16% respectively. Conclusions 125I brachytherapy for late - staged malignant tumors gives a wide range,definite recent efficiency and satisfactory reliability. However,own to all the patients are very latestaged,a high survival rate have not been obtained.
出处
《实用肿瘤学杂志》
CAS
2010年第1期41-44,共4页
Practical Oncology Journal
关键词
125I粒子
组织间植入
晚期恶性肿瘤
125I seed
Brachytherapy implantation
Late - staged malignant tumors
