^(125)Ⅰ粒子植入术后肿瘤针道种植转移的临床观察  

Clinical observation on the neoplasm needle track implantation metastasis after percutaneous ^(125)Ⅰ seeds implantation

作　　者：郭立文[1] 俞炎平[1] 江海涛[1] 姚征[1] 练维生[1] GUO Liwen;YU Yanping;JIANG Haitao;YAO Zheng;LIAN Weisheng(Departement of Interventional therapy,Zhejiang Cancer Hospital,Hangzhou,Zhejiang Province 310022,China)

机构地区：[1]浙江省肿瘤医院介入治疗科,杭州310022

出　　处：《介入放射学杂志》2018年第9期870-872,共3页Journal of Interventional Radiology

基　　金：浙江省医药卫生科技计划项目(2012KYB026)

摘　　要：目的探讨经皮^(125)Ⅰ粒子植入术后肿瘤针道种植转移的临床观察。方法回顾性分析2007年1月至2017年1月接受CT导引下经皮^(125)Ⅰ粒子植入治疗1 260例患者临床资料。结果 6例(0.48%,6/1 260)患者发生针道种植转移,其中肝癌4例,肺癌2例,患者平均使用穿刺针(9.5±3.8)根;平均植入粒子数(80.8±42.9)颗;发现针道种植转移的平均时间为(113.7±34.3)d;种植瘤平均体积8.09 cm3;病理结果示3例低分化,2例中低分化,1例为高分化。针对转移灶治疗方式:1例放弃治疗,3例行^(125)Ⅰ粒子植入治疗,1例行外科切除,1例行常规放射治疗,治疗的5例患者均取得良好的肿瘤局部控制效果,无患者因针道转移病灶导致死亡。结论经皮^(125)Ⅰ粒子植入治疗后可能发生肿瘤针道种植转移,但发生率低,经过积极治疗后,不会成为患者的致死因素。Objective To discuss the clinical features of neoplasm needle track implantation metastasis after125 I seed implantation. Methods The clinical data of 1260 patients, who received CT-guided percutaneous125 I seeds implantation during the period from January 2007 to January 2010 at authors＇ hospital, were retrospectively analyzed. Results A total of 6 patients（0.48%,6/1260） developed neoplastic needle tract seeding, including 4 patients with liver cancer and 2 patients with lung cancer. The average number of used puncture needle was（9.5±3.8） needles, the average number of implanted125 I seed was（80.8±42.9） seeds. The mean time to discover needle track implantation metastasis was（113.7 ±34.3） d, and the mean volume of implanted tumor was 8.09 cm3. Pathological examination showed that poorly-differentiated cancer was seen in 3 patients, mid-poorly-differentiated cancer in 2 patients, and well-differentiated cancer in one patient. One patient gave up treatment, 3 patients received CT-guided percutaneous125 I seeds implantation, one patient underwent surgical resection, and one patient received routine radiotherapy.Satisfactory local control effect of tumor was obtained in all 5 patients who received treatments. No death due to neoplasm needle track implantation metastasis occurred. Conclusion Neoplasm needle track implantation metastasis may occur after percutaneous125 I seeds implantation therapy, although the incidence is extremely low. Usually, neoplasm needle track implantation metastasis will not become the lethal factor when active treatment is properly adopted.

关 键 词：125Ⅰ粒子 近距离放射治疗 针道 种植转移 

分 类 号：R735.7[医药卫生—肿瘤]