^(32)P制剂内照射治疗难治性实体瘤的临床研究  

Clinical study on treatment of refractory solid tumor by intervention with ^(32)P colloids or microspheres

作　　者：高宏[1] 刘璐[1] 滕皋军[2] 封国生[1] 张士东[1] 童冠圣[3] 郭金和[2] 刘龙[1] 高乃荣[4] 

机构地区：[1]北京世纪坛医院肿瘤治疗中心,100038 [2]东南大学附属中大医院介入放射科 [3]北京世纪坛医院核医学科 [4]东南大学附属中大医院肝胆外科

出　　处：《中华放射医学与防护杂志》2006年第1期43-47,共5页Chinese Journal of Radiological Medicine and Protection

基　　金：铁道部科研基金资助项目(J1998Z021);江苏省卫生厅科研基金资助项目(H200117)

摘　　要：目的研究32P胶体或微球治疗难治性实体瘤的疗效。方法30例难治性实体瘤患者经动脉内介入,手术野直视或在CT引导下经皮注入瘤体内部,接受32P胶体或微球(259~685MBq)治疗,通过γ照相机、X线平片及CT来观察抑瘤率、副作用及生存期。结果瘤体内注射32P制剂后肿瘤生长明显受到抑制。患者的平均生存期为33个月,抑瘤率为96.6%,完全抑制16例占53.3%,部分抑制13例占43.3%。其中1例右叶肝癌患者已带瘤生存至今94月。仅1例治疗无效,治疗后出现放射性肺显影、肝功能衰竭死亡。未出现其他明显副作用。病理检查结果表明,瘤体高度纤维化,内见坏死区,外层形成完整包膜。结论32P胶体或微球是放射性核素治疗难治性实体瘤的理想药物。合理选择适应证和给药方法能进一步提高临床疗效。Objective To study the therapeutic effectiveness of ^32P colloids or microspheres in treatment of the solid tumors. Methods Thirty patients with refractory solid tumor served as the objects of investigation. After the tumor size was defined by CT scan, ^32P colloids or microspheres （259-685 MBq） were administered through intra-arterial intervention or injected into the tumor proper under direct vision during operation or through per cutaneous injection under the guidance of CT or X-ray. The tumor inhibiting rate, side effect and surviving time were observed through γ camera, X-ray plan film, CT, uhrasonography and hematological assay. Results The tumor growth was prominently inhibited after the intra-tumoral injection of ^32P preparations. The average surviving time of the patients was 33 months, the tumor-inhibiting rate was 96.6%. Complete inhibition was shown in 16 cases （53.3 % ） and partial inhibition in 13 cases （43.3 % ）. The longest survivor, one patient with right lobe hepatic carcinoma, has been living up to now for at least 94 months. Prominent side effects did not occur but one patient with radiation lung development died from hepatic failure, and the results of pathological examination revealed intra-tumoral necrosis, highly fibrosed tumor mass and an integrated capsule as the outmost layer. Conclusion ^32P colloids or microspheres are the ideal radioactive agents for the treatment of refractory solid tumors. Further improving the clinical therapeutic effectiveness through rational solid selection of indications and/or procedures for administration of these agents is strictly required.

关 键 词：难治性实体瘤 介入治疗 磷放射性核素 ^32P制剂内照射治疗 

分 类 号：R730.5[医药卫生—肿瘤]