CT引导下125I粒子植入治疗腹膜后淋巴结转移癌临床应用分析  

Clinical application of CT-guided 125I seed implantation for retroperitoneal lymph node metastases

作　　者：吕洋 吕维富 汪红梅 周春泽 LYU Yang;LYU Wei-fu;WANG Hong-mei(Department of Interventional Radiology,the First Affiliated Hospital of University of Science and Technology of China,Hefei,Anhui 230001,China)

机构地区：[1]中国科技大学第一附属医院介入放射科

出　　处：《中华全科医学》2019年第12期2008-2012,共5页Chinese Journal of General Practice

基　　金：安徽省科技攻关项目(1704a0802152)

摘　　要：目的探讨在CT引导下经皮穿刺植入放射性125I粒子治疗有症状的腹膜后淋巴结转移患者的临床疗效。方法于2015年4月-2019年1月对在中国科技大学第一附属医院诊治的35例病理证实的恶性肿瘤伴腹膜后淋巴结转移的患者,采用CT引导下植入放射性125I粒子的方法进行治疗。治疗前先应用计划系统(TPS)做淋巴结的重建三维图像,然后计算125I粒子的相应数量和分布。CT引导下经皮、经肝植入粒子。评价患者1年生存率、临床获益率、客观有效率,观察并发症情况。结果患者随访期为5~18个月,平均时间为7个月。难治性疼痛的症状得到了显著的改善,卡氏评分明显上升。术后1、3、6、9、12个月患者生存率分别为100.00%、100.00%、71.42%、54.29%、48.57%。客观有效率分别为69.49%、79.66%、79.49%、82.39%、70.97%,临床获益率分别为89.83%、91.53%、84.62%、85.29%、77.42%。18例患者死亡。在组织间内照射治疗期间未发生粒子移位或术后骨髓抑制、大出血、感染、放射性腹膜炎、放射性肠炎、瘘等严重并发症。结论CT引导下125I粒子植入治疗恶性肿瘤伴腹膜后淋巴结转移的病例,在改善患者生存质量方面是可行的、安全的、有效的。Objective To explore the clinical efficacy of CT-guided radioactive 125I seed implantation in treating retroperitoneal lymph node metastases.Methods From April 2015 to January 2019,35 patients pathologically confirmed malignant tumor with retroperitoneal lymph node metastasis received CT-guided radioactive 125I seed implantation.Three-dimensional images of lymph nodes were reconstructed using the treatment planning system(TPS)before treatment,and the corresponding number and distribution of 125I seeds were calculated.CT-guided percutaneous and transhepatic seed implantation.The 1-year survival rate,clinical benefit rate,response rate,and the complications were evaluated.Results Patients were followed up for 5-18 months,with an average of 7 months.Symptoms of refractory pain were significantly resolved,while the Karnofsky score was significantly increased.The 1-year survival rate of 1,3,6,9 and 12 months after operation was 100.00%,100.00%,71.42%,54.29%and 48.57%,respectively.The response rate was 69.49%,79.66%,79.49%,82.39%and 70.97%,respectively.The clinical benefit rate was 89.83%,91.53%,84.62%,85.29%and 77.42%,respectively.Eighteen patients died.There were no serious complications such as particle displacement,postoperative bone marrow suppression,massive hemorrhage,infection,radioactive peritonitis,radioactive enteritis and fistula.Conclusion CT-guided 125I seed implantation for malignant tumor with retroperitoneal lymph node metastasis is feasible,safe and effective in improving patient quality of life.

关 键 词：腹膜后转移性淋巴结 125I粒子植入 近距离放射治疗 

分 类 号：R815[医药卫生—放射医学] R816.5[医药卫生—临床医学]