^125I粒子植入复发转移鳞癌术后2个月动态剂量研究  

Dynamic dose study of^125I seed implantation in treating recurrent and metastatic squamous cell carcinoma at two months after surgery

作　　者：陈恩立 王娟[2] 赵金鑫[2] 刘泽洲[2] 徐克 梁岩松 张宏涛[2] CHEN Enli;WANG Juan;ZHAO Jinxin;LIU Zezhou;XU Ke;LIANG Yansong;ZHANG Hongtao(Graduate School of Hebei Medical University,Shijiazhuang,Hebei Province 050017,China)

机构地区：[1]河北医科大学研究生学院,石家庄050017 [2]河北省肿瘤放射性粒子植入诊疗中心、河北省放射性粒子近距离治疗研究所、河北省人民医院肿瘤一科

出　　处：《介入放射学杂志》2020年第3期262-266,共5页Journal of Interventional Radiology

摘　　要：目的探讨^125I粒子植入治疗复发转移鳞癌术后2个月动态剂量评价时靶区体积缩小对剂量学参数及疗效、并发症的影响。方法回顾分析2016年7月至2018年11月行^125I粒子植入治疗复发转移鳞癌患者31例,粒子活度0.5~0.8 mCi,处方剂量100~120 Gy。按术后2个月体积缩小百分比分为小于20%(A组)、20%~40%(B组)、大于40%(C组)。观察D90(90%靶体积接受的剂量)、V90(90%处方剂量覆盖的体积占靶体积的百分比)、V100、V150变化,及疗效、并发症。结果A、B两组各剂量学参数较术后即刻减小,差异具有统计学意义(P<0.05);C组V90、V100、V150较术后即刻差异均无统计学意义(P>0.05),D90较术后即刻减小,差异具有统计学意义(P<0.05);C组各剂量学参数差值百分比均大于A、B组(P<0.05)。A、B、C组局部控制率分别为70%、100%、100%,有效率为0、20%、54.5%;三组均未观察到并发症。结论术后2个月肿瘤缩小速度大于40%,疗效更好,但可能出现局部高剂量区,若邻近重要组织器官,存在并发症风险;当小于20%时,靶区内剂量分布不均匀,可能剂量不足,有复发风险。Objective To investigate the dynamic dose of^125I seed implantation in treating recurrent and metastatic squamous cell carcinoma at 2 months after surgery,and to assess the effect of target volume reduction on the dosimetric parameters,curative efficacy and complications.Methods The clinical data of 31 patients with recurrent metastatic squamous cell cancer,who received^125I seed implantation during the period from July 2016 to November 2018 at authors’hospital,were retrospectively analyzed.Seed activity was 0.5-0.8 mci and the prescription dose was 100-120 Gy.According to the volume reduction percentage of tumor at 2 months after surgery,the patients were divided into group A(reduction<20%),group B(reduction 20%-40%)and group C(reduction>40%).The changes in D90(the dose received by 90%target volume),V90(the percentage of the volume covered by 90%prescription dose in target volume),V100 and V150,as well as the curative efficacy and the occurrence of complications were recorded.Results All the dosimetric parameters in group A and group B were obviously decreased when compared with immediate postoperative data,the differences were statistically significant(P<0.05).In group C,the immediate postoperative differences in V90,V100 and V150 were not statistically significant(P>0.05),although the immediate postoperative difference in D90 was decreased,and the difference was statistically significant(P<0.05).The percentages of differences in all dosimetric parameters of group C were remarkably larger than those of group A as well as of group B(P<0.05).In group A,group B and group C,the local control rates were 70%,100%and 100%respectively,the effective rates were 0.0%,20.0%and 54.5%respectively.No complications were observed in all three groups.Conclusion At 2 months after surgery,if the reduction rate of tumor is more than 40%,the patient can get a better curative effect,although local high dose area may occur.At this situation,if there are important tissues and organs near the high dose area,there may be a risk of comp

关 键 词：近距离放射治疗 复发转移癌 鳞癌 剂量学 

分 类 号：R73.3[医药卫生—肿瘤]