放射性粒子^(125)I植入治疗晚期结直肠癌9例分析  

Radioactive Seeds Iodine-125 Implantation in Treatment of Advanced Colorectal Cancer: Report of Nine Cases

作　　者：刘艳[1] 李清春[2] 侯睿智[2] 

机构地区：[1]吉林大学中日联谊医院超声科,吉林长春130033 [2]吉林大学中日联谊医院胃肠外科,吉林长春130033

出　　处：《中国普外基础与临床杂志》2015年第10期1222-1225,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨超声引导下放射性粒子125I组织间永久植入治疗晚期结直肠癌的可行性、近期临床疗效及安全性。方法本研究纳入9例患者,均来自吉林大学中日联谊医院2012年10月至2014年10月期间收治的患者,均经严格的病例筛查。其中男5例,女4例;年龄46~78岁,中位年龄54岁;5例患者伴有疼痛症状。病灶总数14个:局部肿瘤复发灶1个,盆腔转移灶2个,肝转移灶8个,腹腔淋巴结转移灶3个。125I放射性粒子植入前CEA水平升高者6例。全部病例经CT、MRI检查或穿刺活检病理学检查证实为转移癌。采用超声实时引导植入125I放射性粒子,治疗后2个月复查CT,观察患者疼痛缓解程度、肿瘤局部控制情况及并发症发生情况。结果125I放射性粒子植入术后2个月复查CT,肿瘤完全缓解2列,部分缓解5例,稳定1例,进展1例;总有效者占7/9,疾病控制者占8/9。5例伴有疼痛患者治疗后疼痛均有所缓解。1例患者术后复查腹部CT发现腹腔内1枚金属粒子游走;术中及术后患者无严重并发症。结论超声引导下放射性粒子125I植入治疗晚期结直肠癌能明显缓解其临床症状,改善生活质量,并能有效控制转移灶,安全可行,且术后住院时间短,具有安全、有效、并发症发生率低等优势。Objective To evaluate the viability, short-term clinical efficacy, and safety of ultrasound-guided radioactive seed ~sI permanent implantation in tissue in patients with advanced colorectal cancer. Methods A total of 9 patients were recruited in this study. All of the patients came from China-Japan Union Hospital of Jilin University from October 2012 to October 2014, which had been selected after strict screening. Five cases of male patients, 4 cases of female patients; the age was between 46-78 years old, the median age was 54 years old. There were 5 cases of patients with pain. There were 14 lesions in total, 1 lesion was local tumor recurrence, 2 lesions were pelvic metastasis, 8 lesions were liver metastases, and 3 lesions were abdominal lymph node metastasis. CEA increased in 6 cases before implantation. All patients were confirmed metastasis by CT, MRI examination or pathology. The 125I radioactive seed implantation was guided by real-time ultrasound. CT scanning was taken in two months after treatment. The degree of pain relief, tumor local control, and the occurrence of complications were observed. Results In 2 months after implantation of 125I radioactive particles, the CT scanning results showed that 2 cases obtained complete response （CR）, 5 cases obtained partial response （PR）, 1 case got stable disease （SD）, and 1 case got progress disease （PD）. Total effective was 7/9, and disease control was 8/9. Five cases with pain symptoms were relieved after treatment. One walk metal particle in the abdominal cavity was found by abdominal CT scanning in 1 case. There were no serious complications intraoperative and postoperative. Conclusions Ultrasound guided radioactive seeds 125I implantation in the treatment of advanced colorectal cancer can significantly relieve the clinical symptoms, improve the quality of life, and can effectively control the metastasis. It is safe and feasible, and the postoperative hospitalization time is short, it has the avantages of safety, effectiveness, and low inci

关 键 词：125I放射性粒子 组织间永久植入 结直肠癌 超声 

分 类 号：R735.34[医药卫生—肿瘤]