肿瘤内注射^(90)Y核素治疗疗效的预测  

Therapeutic Efficiency Prognostication for Tumor Therapy with ^(90)Y Nuclide

作　　者：陈英茂[1] 耿建华[2] 田嘉禾[1] 邵明哲[1] 丁勇[1] 陈盛祖[2] 

机构地区：[1]解放军总医院核医学科,北京100853 [2]中国协和医科大学肿瘤医院核医学科,北京100021

出　　处：《肿瘤防治杂志》2003年第12期1241-1244,共4页China Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金资助项目 ( 3 0 2 70 40 8)

摘　　要：目的 :为了探讨肿瘤内注射 90 Y核素治疗疗效 ,对治疗中吸收剂量、细胞存活率的时空分布和肿瘤控制概率进行研究。方法 :依据肿瘤注射β核素治疗过程中的数学模型 ,由计算机模拟实验肿瘤中心注入 74MBq90 Y核素 0 5mL时 ,吸收剂量、细胞存活率的时空分布 ,以及肿瘤控制概率与肿瘤大小、治疗时间的关系。结果 :1)吸收剂量随径向距离急速下降 ;2 )细胞存活率随时间先下降达最小值后又回升 ;3)肿瘤控制概率经历 4个时期 :上升期、治愈期 (>0 99)、下降期和复发期。并随肿瘤体积增大 ,治愈期快速缩短。结论 :吸收剂量的分布极度不均 ,使控制概率高度依赖肿瘤大小 ;Objective To investigate the radiation absorbed dose, clonogenic cells survival fraction and TCP(tumor control probability) during tumor therapy with interstitial injection of Beta radionuclide in order to prognosticate the therapeutic efficiency.Methods The process of curing tumor with 90Y(74 MBq) 0.5 mL injected into tumor center was simulated with the computer program based on the mathematical model we had built.The spatial and time distribution of absorbed dose and clonogenic cells survival fraction and the relationships between TCP and tumor size and curative time were obtained.Results 1)The absorbed dose falls down sharply in radial direction.2)The surviving fraction decreases first and then increases along time.3)Tumor control probability goes through four stages:an initial fast rise stage;a curable stage in which the TCP is higher than 0.99;a next rapid fall stage;and a last recurrence stage.And the duration of every stage is tumor size dependent,the curable stage rapidly shortens as tumor size increases.Conclusions The distribution of the radiation absorbed dose quickly varies within it’s range,so TCP is highly dependent on the tumor size.The tumor control probability is the best index to prognosticate the therapeutic efficiency and direct the doctor to use correctly nuclide dose in clinic.

关 键 词：锶放射性同位素 吸收剂量 细胞存活率 肿瘤控制概率 

分 类 号：R730.5[医药卫生—肿瘤]