超声引导下^(125)I粒子植入治疗胃癌肝转移38例  

Ultrasound-guided ^(125)I seed brachytherapy for the treatment of gastric cancer with liver metastasis

作　　者：张源[1] 沈加林[1] 丁敏[1] 杜冬伟 王振宇 李伟建 景宏舒 翟博[1] ZHANG Yuan;SHEN Jialin;DING Min;DU Dongwei;WANG Zhenyu;LI Weijian;JING Hongshu;ZHAI Bo(Department of Interventional Oncology,Affiliated Renji Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院肿瘤介入科,200127

出　　处：《介入放射学杂志》2018年第8期770-774,共5页Journal of Interventional Radiology

基　　金：上海市科委课题项目(14DZ1941000)

摘　　要：目的评价超声引导下^(125)I粒子治疗胃癌肝转移的临床疗效。方法 38例胃癌肝转移患者术前利用计算机治疗计划系统(TPS)计算布源,术中行超声引导下125I粒子植入手术,术后进行剂量验证和质量评估。评价指标包括患者术后1、6个月肿瘤的CT、MR影像变化,术后并发症,肿瘤局部控制率和复发转移率,无进展生存期(PFS)和总生存期(OS)。结果所有手术顺利完成,中位随访时间13个月。术后出现2例轻微疼痛,1例高胆红素血症,未见肝肾功能衰竭、放射性肠炎等严重并发症,无围手术期死亡。术后6个月肿瘤局部控制率80%,复发转移率28.9%;无瘤生存期5个月,6个月无瘤生存率46.9%;整体生存期16.4个月,6个月整体生存率81.4%。结论超声引导下^(125)I粒子植入治疗胃癌肝转移,临床近期疗效确切,是一种安全有效的治疗方法。Objective To evaluate the therapeutic efficacy of ultrasound-guided ^（125） I seed brachytherapy in treating gastric cancer with liver metastasis（GCLM）. Methods Treatment plan system（TPS） was used to design the distribution of ^（125） I seeds for 38 patients with GCLM before operation. Ultrasound-guided ^（125） I seed implatation was performed for all patients. Postoperative dose verification and quality assessment were conducted. The evaluating indicators included the imaging changes of CT/MR performed at one and 6 months after the treatment, the postoperative complications, the local control rate and recurrence rate of tumor, the progress-free survival（PFS）, and the overall survival（OS）. Results Successful implantation of ^（125） I seeds was accomplished in all patients. The median follow-up time was 13 months. After the treatment, slight pain was seen in 2 patients, and hyperbilirubinemia was observed in one patient. Neither serious complications such as liver failure, renal failure or radioactive enteritis, nor perioperative death occurred. Six months after the treatment, the local control rate was 80% and the recurrence and metastasis rate was 28.9%. The DFS was 5 months and the 6-month DFS rate was 46.9%. The OS was 16.4 months and the 6-month OS rate was 81.4%.Conclusion For the treatment of GCLM, ultrasound-guided ^（125） I seed brachytherapy is safe and effective with reliable short-term cinical effect.

关 键 词：胃癌肝转移 放射治疗 ^125I粒子 临床疗效 

分 类 号：R735.7[医药卫生—肿瘤]