CT引导下^(125)Ⅰ粒子植入内照射治疗肝门部转移性肿瘤11例  

CT- guided ^(125)Ⅰ seed implantation brachytherapy for metastases at hepatic hilum: preliminary results of 11 cases

作　　者：李杰[1] 谢其根[1] 王卫国[1] 华燕艳[1] 程云[1] 李玲[1] 赵俊功[2] 朱晓黎[3] 

机构地区：[1]江南大学附属医院(无锡市第四人民医院)介入科,江苏无锡214000 [2]上海交通大学附属第六人民医院放射介入科 [3]苏州大学附属第一医院介入科

出　　处：《介入放射学杂志》2015年第11期969-972,共4页Journal of Interventional Radiology

基　　金：无锡市医院管理中心科技发展基金(YGM1123)

摘　　要：目的初步探讨CT引导下^(125)I粒子植入内照射治疗肝门部转移性肿瘤的安全性和有效性。方法对2011年5月至2014年5月收治的11例存在肝门区转移瘤患者,经CT引导下^(125)I粒子植入内照射治疗后进行回顾性研究。经治疗计划系统制定计划,CT引导下经自制定位栅定位后,按计划植入0.7 m Ci粒子,处方剂量为90~120 Gy,术中验证瘤体体积90%,得到90%以上的处方剂量,术后做等剂量曲线进行验证评估。术后2、4、8周和6个月随访复查肿瘤局部控制情况评价疗效。结果所有患者经过^(125)I粒子植入内照射治疗后临床症状均有改善,2周后完全缓解+部分缓解(CR+PR)6例(54.6%),4~8周直至6个月后CR+PR 9例(81.8%)。3例CR,6例PR,粒子植入后局部病灶均无进展,无严重并发症。结论 CT引导下^(125)I粒子植入内照射治疗肝门部转移性肿瘤只要达到足够的照射剂量短期内就可以取得良好的局部控制,具有并发症少、简便安全等优点,是肿瘤综合治疗的重要方法。Objective To investigate the safety and feasibility of internal radiation therapy with CT- guided ^125I seed permanent implantation for metastases at hepatic hilum. Methods The clinical data of 11 patients with metastases at hepatic hilum, who were admitted to authors＇ hospital during the period from May 2011 to May 2014 to receive CT-guided ^125I seed permanent implantation therapy, were retrospectively analyzed. The therapeutic plan was formulated by treatment planning system. Under CT guidance the positioning procedure was performed with the help of self-made positioning grid, then implantation of 0.7 mCi ^125I seeds was carried out according to the plan, the prescription dose was （90-120） Gy. Intra-operative validation was conducted to ensure that 90% of the tumor volume received more than 90% of the prescribed dose. After the treatment, the isodose curve was drawn to make validation evaluation. Follow-up reviews were made at 2, 4, 8 weeks and 6 months after the treatment to check the local control of tumor. Results After the treatment, the clinical symptoms were improved in all patients. Two weeks after the treatment, the complete remission plus partial remission（PR＋CR） was 54.6%, which increased to 81.8% at 4-8 weeks after 6 months. Of the 11 patients, CR was obtained in 3 and PR in 6. After ^125I seed implantation the local lesion showed no progress, and no serious complications occurred. Conclusion As long as the radiation dose is adequate, CT-guided internal radiation therapy with ^125I seed implantation can achieve, in a short time, excellent local control rate for metastases at hepatic hilum. This therapy has certain advantages such as technically- simple, clinically- safe, fewer complications, etc. Therefore, it is an important method for the treatment of tumor.

关 键 词：近距离放射治疗 ^125I粒子植入 CT引导下 转移瘤 肝门区 

分 类 号：R735.7[医药卫生—肿瘤]