靶区和剂量控制下125Ⅰ粒子治疗颅内恶性肿瘤的再评价  

Evaluation of CT-guided iodine-125 seeds brachytherapy for intracranial malignant tumors under control of target and dose

作　　者：胡效坤[1] 彭丽静[2] 刘士锋[1] 张开贤[3] 刘院生 张福君[5] 朱旭东[6] 巩秀珍[7] 高阳[8] 王德峰[9] Tina Kapur 李子祥[1] 

机构地区：[1]青岛大学附属医院介入医学中心,266555 [2]青岛大学附属医院检验科,266555 [3]山东省滕州市中心人民医院肿瘤科 [4]上海中大肿瘤医院肿瘤科 [5]中山大学附属肿瘤医院医学影像与肿瘤微创中心 [6]山东省邹平中医院肿瘤科 [7]青岛大学医学院松山医院内科 [8]北京航空航天大学仪器科学与光电工程学院 [9]香港中文大学医学影像计算研究中心 [10]哈佛医学院放射科

出　　处：《中华医学杂志》2017年第19期1457-1462,共6页National Medical Journal of China

摘　　要：目的再次评价靶区和剂量控制下125I粒子治疗颅内恶性肿瘤的疗效和并发症。方法回顾分析2003年11月—2016年5月青岛大学附属医院、山东省滕州市中心人民医院、山东省邹平中医院等12家医院310例颅内恶性肿瘤患者412次手术的临床资料，分析靶区和剂量控制下125I粒子治疗颅内恶性肿瘤的技术，评价疗效和并发症。对颅内恶性肿瘤进行分层研究，行靶区和剂量控制下125I粒子治疗。结果单发脑转移瘤、低级别胶质瘤、高级别胶质瘤、手术后复发、放疗后复发、其他（脑膜瘤、垂体瘤等）中位生存期分别是19、67、41、26、23、46个月；中位无进展生存时间分别是19、42、6、9、11、12个月。并发症种类多，发生率低，总并发症发生率10.4%；术后7～45 d死亡3例。结论靶区和剂量控制下125I粒子治疗颅内恶性肿瘤可以取得较好的疗效，而并发症较低，与外科切除、外放射治疗各具特点，应该进一步研究，并形成临床路径。Objective To assess the efficacy and safety of CT-guided iodine-125 seeds in the treatment of intracranial malignancies under control of target and dose. Methods From November 2003 to May 2016, with the clinical data of 412 operations on 310 patients in 12 hospitals in the past 14 years, this study analyzed the method of CT guided iodine-125 particles brachytherapy in the treatment of intracranial malignant tumors and evaluated the efficacy and complications. Stratification analysis of intracranial malignant tumors was performed. Results Overall survival （OS） of patients with single brain metastases, low-grade glioma, high-grade gliomas, recurrence after surgery, recurrence after radiotherapy and others were 19, 67, 41, 26, 23, 46 months respectively. And the progression free time （PFS） of patients with single brain metastases, low-grade glioma, high-grade gliomas, recurrence after surgery, recurrence after radiotherapy and others were 19, 42, 6, 9, 11, 12 months respectively. Various complications were observed with a relatively low incidence of 10. 4%. Three cases deceased at an interval of 7 -45 days after treatment. Conclusions For patients with intracranial malignancies, iodine-125 seeds brachytherapy could achieve a satisfactory treatment efficacy with tolerated complications. Iodine-125 seeds brachytherapy may act as a first-line regimen.

关 键 词：近距离放射疗法 放射治疗剂量 脑肿瘤 碘-125粒子 

分 类 号：R730.55[医药卫生—肿瘤] R739.41[医药卫生—临床医学]