MSCT引导下^(125)I粒子植入治疗恶性肿瘤的应用价值  

Interstitial ^(125)I seed implantation in the treatment for refractory malignant tumor under the guidance of MSCT

作　　者：高建华[1] 赵相胜[1] 商健彪[1] 

机构地区：[1]暨南大学医学院第六附属医院江门市五邑中医院,广东江门529031

出　　处：《中国临床医学影像杂志》2008年第3期198-202,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨在MSCT引导下经皮穿刺125I粒子组织间植入治疗恶性肿瘤的安全性、疗效及应用价值。方法:70例恶性肿瘤76个病灶,瘤体直径2.5～12.0cm,平均6.5cm。根据粒子植入术前14天MSCT图像,采用治疗计划系统(TPS)制定粒子植入计划,按计划在MSCT引导下经皮穿刺准确植入125I粒子。植入后即刻及术后2～8个月CT复查观察粒子在瘤体内的分布、有无并发症发生及疗效。结果:70例恶性肿瘤粒子植入均顺利完成,单个瘤体内植入粒子数分别为10～90粒(平均45粒)。70例粒子植入患者中66例71个病灶内粒子分布满意,4例5个病灶粒子分布欠均匀,4例5个病灶分别于术后4～8周对肿瘤区进行补充粒子植入。70例恶性肿瘤76个病灶,完全缓解(CR)5个;部分缓解(PR)45个;无变化(NC)15个;进展(PD)11个。总有效率65.79%(50/76)。仅在肺癌的植入粒子治疗后,15例中有4例出现少量气胸,保守治疗后痊愈。未见其他严重并发症和治疗相关的放射性损伤。结论:在MSCT引导下经皮穿刺125I粒子组织间植入治疗恶性肿瘤是一种简便易行、安全有效的微创治疗手段。Objective： To evaluate the safety and efficacy of percutaneous MSCT guided interstitial ^125Ⅰseed implantation treatment for refractory malignant tumor. Methods： Seventy-six lesions（diameter 2.5-12.0cm, mean 6.5cm） in 70 refractory malignant tumor patients underwent percutaneous MSCT guided intratumoral ^125Ⅰ seed implantation. Treatment plan system（TPS） was adopted based on CT imaging 14 days before the procedure. The distribution of ^125Ⅰ seed, complications and efficacy were observed immediately after and 2-8 months after the procedure. Results： The procedure of intratumoral ^125Ⅰ seed implantation in 76 malignant tumors was successful. Ten to ninety particles（mean 45） of l^I seeds were implanted into a single tumor. The distribution of seeds in 71 malignant tumors in 66 patients was satisfactory while the distribution of ^125Ⅰseeds in 5 malignant tumors of the other 4 cases was not uniform, and the latter 5 malignant tumors of 4 cases were carried out supplementary ^125Ⅰ seed implantation in the tumor cool area 4-8 weeks after the procedure. The clinical CR and PR were achieved in 5 and 45 lesions respectively, with an overall response rate of 65.79%（50176）. Pneumothorax occurred in 4 cases with lung cancer. No acute complications and treatment related radiation damages occurred in the other cases. Conclusions： The MSCT guided percutaneous intratumoral ^125Ⅰseed implantation treatment for refractory malignancies is a safe and effective method.

关 键 词：肿瘤 碘放射性同位素 体层摄影术 螺旋计算机 

分 类 号：R73[医药卫生—肿瘤] R817.8[医药卫生—临床医学]