^(125)I粒子与缓释化疗粒子联合应用靶向治疗复发性直肠癌  

Radiochemotherapy with interstitial implantation of ^(125)I seeds and 5-FU slow-released seeds for recurrent colorectal adenocarcinoma

作　　者：高宏[1] 李力军[1] 封国生[1] 杜伟生[1] 

机构地区：[1]北京世纪坛医院肿瘤中心,100038

出　　处：《中华放射医学与防护杂志》2006年第4期381-382,共2页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的探讨应用放、化疗粒子联合植入法综合治疗复发性直肠癌的可行性、安全性及短期疗效。方法自2001年12月至2005年12月,应用放、化疗粒子联合植入法综合治疗复发性直肠癌26例,均为直肠癌Mile’s术后盆腔复发病人。在治疗计划指导下,交替植入氟尿嘧啶缓释化疗粒子和放射性125I粒子。放射性粒子的肿瘤匹配周边剂量(matched peripheral dose,MPD)为90~130Gy。平均每例使用125I粒子12粒,氟尿嘧啶600mg。结果26例病人手术均顺利完成,未发生出血、感染等并发症,经盆腔摄片证实放射性粒子的位置无变化。疼痛缓解率为88·9%(16/18),平均疼痛缓解时间为5~10d。于术后3~6个月CT复查肿瘤变化,提示瘤体不同程度缩小,其中2例完全缓解,19例部分缓解,4例稳定,局部控制率为81%。随访6~42个月,中位生存期为29个月,最长1例随访时间为术后42个月,现仍存活。1例术后6个月死于全身广泛转移。结论放射性125I粒子和氟尿嘧啶缓释化疗粒子联合应用局部植入技术具有安全、微创及并发症发生率低的特点,是综合治疗复发性直肠癌较有效的手段之一。Objective To investigate the treatment of interstitial implantation of ^125Ⅰ seeds feasibility, security, and short-term efficacy of combined and 5-FU slow-released seeds for recurrent colorectal adenocarcinoma. Methods From December 2001 to December 2005, 26 cases of recurrent colorectal adenocarcinoma underwent Mile＇s procedure were treated with the radiochemotherapy. We implanted alternately ^125Ⅰ seeds and 5-FU slow-released seeds following the treatment planning system. The matched peripheral dose （MPD） of ^125Ⅰ seed implantation was 90-130 Gy. Twelve granules of ^125^Ⅰ seeds and 600 mg of 5-FU were administered in every patient on average. Results No operation-related complication was occurred during the implantations for all the cases. No displacement of ^125Ⅰ seed was found by pelvic X-ray examination. Lenitive rate of the pain was 88.9% （16/18） .The relief has lasted for 5-10 days on average. CT scanning showed that the size of tumor reduced in various degree at 3-6 months after the implantation. The complete recovery rate was 7.7% （2/26）, the partial recover）＇ rate was 73.1% （ 19/26）. The PD was 15.4% （4/26）. The median survival time was 29 months estimated by following these cases for 6-42 months. One case died of bone and lung metastases at 6 months after the implantation. Conclusion Combined radiochemotherapy with interstitial implantation of ^125Ⅰ seeds and 5-FU slow-released seeds was a safe and effective microinvasive treatment for recurrent colorectal carcinoma.

关 键 词：直肠肿瘤 ^125Ⅰ粒子 氟尿嘧啶缓释化疗粒子 近距离治疗 

分 类 号：R735.37[医药卫生—肿瘤]