^125Ⅰ粒子植入治疗胃癌有效性与安全性评价  

The effectiveness and safety of ^125Ⅰ seed implantation for treatment of gastric cancer

作　　者：邹雷[1,2] 罗开元[2] 马振桓[2] 李波[2] 李晓刚[2] 许建彪[2] 陆炯[3] 

机构地区：[1]昆明医科大学第四附属医院、云南省第二人民医院普外科,650021 [2]云南省第一人民医院肝外科650032 [3]昆明医科大学第四附属医院、云南省第二人民医院核医学科,650021

出　　处：《中华核医学与分子影像杂志》2013年第4期248-251,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：云南省2008年社会发展科技计划第五批实施（应用基础研究重点）项目（2008CC002）

摘　　要：目的探讨^125Ⅰ粒子组织间植入治疗胃癌的有效性及该方法能否提高患者生存率。方法选取同时期Ⅱ、Ⅲ期胃癌患者76例，按单纯随机分为根治性手术组（34例，仅行根治性手术，D2、D3术式）和根治性手术＋^125Ⅰ粒子组（42例，行根治性手术＋^125Ⅰ粒子治疗）。治疗效果分CR（治疗后肿瘤完全消失达1个月以上）、PR（肿瘤较治疗前缩小50％以上至少1个月）、NC和PD，CR＋PR为治疗有效，据此计算有效率。随访并计算患者生存率及并发症发生情况。率的比较采用X^2检验。结果根治性手术组总有效率50．00％（17／34），根治性手术＋^125Ⅰ粒子组总有效率为73．81％（31／42），2组差异有统计学意义（X^2=4．578，P〈0．05）。根治性手术＋^125Ⅰ粒子组3年和5年生存率分别为61．90％（26／42）和42．86％（18／42），均高于根治性手术组[11．76（4／34）和0（0／34）；X^2=19．771和19．094，均P〈0．001]。2组毒性和不良反应均较少。结论根治性手术＋Ⅰ粒子植入治疗Ⅱ、Ⅲ期胃癌较单纯根治性手术更有效，能进一步提高远期生存率，不良反应少。Objective To explore the effectiveness of 125I seed implantation for gastric cancer and to determine whether the therapy could increase the survival rate. Methods Seventy-six gastric cancer patients in stage Ⅱ or In were involved and randomly divided into treatment group （n = 42） and control group （n = 34） by simple random sampling method. The patients in the control group underwent D2 or D3 surgery and the pa- tients in treatment group underwent D2 or D3 surgery plus interstitial implantation of Ⅲ seeds. All patients signed the informed consents. Treatment results were evaluated as CR, PR, NC and PD. CR and PR were considered as effective and the effective rate was calculated. All patients were followed up and the three- or five-year survival rate was calculated, the complications were examined. X2 test was used to compare the signif- icant difference between the two groups. Results The total effective rate in control group was 50.00% （17/ 34）, lower than that of treatment group （73.81% ,31/42; X^2 =4.578, P〈0. 05）. In the treatment group, the three-year and five-year survival rates were 61.90%（26/42） and 42. 86%（18/42） respectively, and the cor- responding rates in the control group were 11.76% （4/34） and 0（0/34） respectively （X2 = 19. 771, 19. 094, both P〈0.001）. Both of the two groups had few severe side effects. Conclusion Radical surgery plus ^125Ⅰ seed implantation is effective and safe for the treatment of stage Ⅱ or Ⅲ gastric cancer and can further improve long-term survival.

关 键 词：胃肿瘤 近距离放射疗法 碘放射性同位素 

分 类 号：R735.2[医药卫生—肿瘤]