术中瘤内置管后装放疗治疗转移性肝癌  

High-dose rate interstitial irradiation of hepatic metastases from colorectal carcinoma

作　　者：孟岩[1] 金冶宁[1] 王雅杰[1] 孙志宏[2] 张柏和[2] 余友渔[1] 

机构地区：[1]第二军医大学长海医院放射治疗科,上海市200433 [2]第二军医大学东方肝胆外科医院

出　　处：《中华肝胆外科杂志》2002年第7期425-427,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　观察转移性肝癌组织间插植后装放疗的效果、毒副反应 ,探讨其应用于治疗结、直肠癌术后肝转移的可行性。方法　 1992年 11月至 1997年 5月对 18例结、直肠癌术后确诊肝转移病人行剖腹探查术中瘤内置管组织间插植后装放疗。放射源为高剂量率192 Ir,每次照射 8～ 10Gy ,总量 30～ 4 0Gy ,1～ 2周内完成。结果　 18例无明显毒副反应 ,中位生存期 2 5 6个月 ,1,3,5年生存率(按寿命表法 )分别为 71 6 % ,2 8 7% ,7 2 %。CEA滴度变化可做为肿瘤控制与否及有无肝内外隐匿病灶的重要指标。结论　术中、肝穿刺置管法安全、可靠 ;作为局部根治性治疗手段 ,对原发于结、直肠的肝转移癌的治疗是有效的。Objective To evaluate the results and radiation toxicity and explore feasibility of high dose rate interstitial brachytherapy of hepatic metastases from colorectal carcinoma. Methods From November 1992 to May 1997, 18 patients with unresectable hepatic metastases of colorectal carcinoma received interstitial irradiation under laparotomy. The radiation resource was HDR 192 Ir. All the patients received 8～10 Gy/F, with a total dose of 30～40 Gy/3～5 F for 1～2 weeks. Results No acute or chronic radiation toxicity was found in the follow up study. The median survival time was 25.6 months. The 1 , 3 and 5 year survival rates were 71.6%, 28.7% and 7.2%, respectively. CEA could be used as an important marker to determine whether there were metastases in or out of the liver. Conclusions This innovative and radical approach to unresectable hepatic metastases of colorectal carcinoma has proved its safety, reliability and effectiveness. Further studies are needed to determine whether interstitial irradiation is as effective as surgical resection.

关 键 词：瘤内置管后装放疗 治疗 转移性肝癌 手术中 

分 类 号：R735.7[医药卫生—肿瘤] R730.55[医药卫生—临床医学]