CT引导^(125)I放射性粒子植入治疗复发性直肠癌32例报告  

作　　者：张开贤[1] 李苓[1] 邢超[1] 张开国[1] 袁倩倩[1] 满其荣[1] 王伟[1] 郝崇礼[1] 杨森[1] 

机构地区：[1]山东滕州市中心人民医院肿瘤科,277500

出　　处：《当代医学》2009年第36期13-15,共3页Contemporary Medicine

摘　　要：目的探讨125I放射粒子植入治疗复发性直肠癌的技术方法、疗效和安全性。方法32例直肠癌术后局部复发患者行CT引导125I放射性粒子植入术。全部在局麻下进行,根据术前计划确定粒子数目、空间分布和粒子针数目。单纯粒子治疗肿瘤匹配周边剂量为120～140Gy,既往曾行放射治疗为100～120Gy。粒子活度为0.5～0.7mCi,间距为1.0～1.5cm,共植入粒子20～75颗,术后即刻行CT扫描并进行质量验证,术后定期复查CT。结果完全缓解(CR)10例,部分缓解(PR)18例,无变化(NC)4例,有效率为88%(28/32)。疼痛缓解率为86%(18/21),平均疼痛缓解时间为8d。中位生存时间为12个月,1、2年生存率分别为75%、41%。未出现与治疗相关的严重并发症。结论CT引导125I放射性粒子植入治疗复发性直肠癌具有微创、安全、疗效确切和并发症低等优点,值得进一步推广应用。Objective To investigate the techonological feasibility,efficacy and safety of CT guided 125I seed implantation for recurrent rectum cancer.Methods 32 patients with recurrent rectum cancer were treated with CT guided 125I seed implantation.The procedure was performed under local anesthesia in all patients,and treatment planning system（TPS） was used to calculate the number of seeds,the space distribution and the introduction of the seeding needles.The matched peripheral dose（MPD） of 125I seed implantation ranged from 100～120GY for patients who had had external radiotherapy,and 120～140GY for those who had not.The range of radioactivity of the 125I seed was 0.5～0.7mCi,spacing 1.0～1.5cm,implanting 20～75seeds.All patients had CT scan at 5mm intervals after implantation for quality evaluation.Results CR10（31.3%）,PR18（56.2%）,NC 4（12.5%）,RR 87.5%（28/32）,pain relief ratio 85.7%（18/21）,The average time for pain relief is 8d.The median survival time（MST） is 12mos,the 1a and 2a survival rate was 75% and 41% respectively.No treatment-related complications occurred.Conclusion CT guided 125I seed implantation for recurrent rectum cancer is minimally invasive,safe,effective and causing only mild norbidity,is Worthy of further popularization and application.

关 键 词：直肠肿瘤 肿瘤复发 碘放射性同位素 近距离放射治疗 

分 类 号：R735.37[医药卫生—肿瘤]