摘要
目的探讨^(125)I粒子植入内照射治疗肝内胆管细胞癌(ICC)的可行性、疗效及安全性。方法回顾性分析2014年6月~2015年12月单中心11例ICC患者行^(125)I粒子治疗的临床资料,其中6例合并梗阻性黄疸者,先行经皮经肝胆管引流术(PTCD)或联合^(125)I粒子条置入缓解黄疸。11例肝内实体肿瘤经治疗计划系统(TPS)制定计划,CT引导下按计划植入0.7 mC i粒子,处方剂量为90~120Gy,术后做等剂量曲线进行验证评估。介入治疗1周后复查血常规、生化全套,每1~2月复查增强CT或MRI,根据mRECIST标准进行肿瘤客观反应评估及随访并发症、生存期。结果 11例患者技术上均获成功,其中CR 1例,PR 6例,SD 2例,PD 2例。随访8~26个月,无手术相关死亡;中位生存期为10个月(95%CI:7.915~12.085个月)。术后1例患者并发肝脓肿形成,行脓肿引流术及抗感染治疗后好转。余10例患者未出现严重并发症。结论 ^(125)I粒子植入内照射治疗ICC是安全可行的,中期随访疗效确切。
Objective To investigate the feasibility, efficacy and safety of 125I seeds implantation internal irradiation in treatment of intrahepatic cholangiocarcinoma.Methods This study retrospectively reviewed 11 patients with intrahepatic cholangiocarcinoma who were treated in single-center department from June 2014 to December 2015.Six patients combined with obstructive jaundice were treated with percutaneous transhepatic cholangial drainage or plus the chain of 125I seeds first.All therapeutic plans were formulated by treatment planning system.Implantation of 0.7 mCi 125I particles was carried out with CT guidance, and the prescription dose was 90~120 Gy.The isodose curve was drawn to evaluate the validation after the procedure.Routine blood tests and biochemistry analysis were checked one week later.Every 1 or two months, enhanced CT or MRI was performed to evaluate the complication and objective response rate.Overall survival （OS） was followed up on all patients.Results Procedures of 125I seeds implantation were performed on all 11 patients with technically successful.After 8~26 months follow-up, no death was appeared related to the procedure.Median OS was 10 months （95%CI： 7.915~12.085）.There were 1 CR, 6 PR, 2 SD and 2 PD according to modified Response Evaluation Criteria In Solid Tumors （RECIST）.One patient experienced hepatic abscess after the 125I seeds implantation and underwent percutaneous drainage and antibiotic therapy.No seves complications were observed on other patients.Conclusion 125I seeds implantation internal irradiation in treatment of intrahepatic cholangiocarcinoma was safe and feasible, the mid-term followed-up results were satisfying.With limited sample size, we need further research before clinical promotion.
出处
《医学影像学杂志》
2017年第7期1276-1280,共5页
Journal of Medical Imaging
关键词
肝内胆管细胞癌
梗阻性黄疸
125I粒子
介入治疗
Intrahepatic cholangiocarcinoma
Obstructive jaundice
125I seeds
Interventional therapy
