^(125)I粒子治疗甲状腺癌实际吸收剂量与靶体积变化研究  

Relationship of actual absorbed dose and volumetric change in patients with squamous cell carcinoma of thyroid treated by ^(125)I radioactive seeds

作　　者：刘泽洲[1] 王娟[1] 张宏涛[1] 梁岩松 高贞[1] 赵金鑫[1] 徐克 李慧娟 于慧敏[1] Liu Zezhou;Wang Juan;Zhang Hongtao;Liang Yansong;Gao Zhen;Zhao Jinxin;Xu Ke;Li Huijuan;Yu Huiming(Department of Oncology,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]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,石家庄050051

出　　处：《中华内分泌外科杂志》2022年第1期50-53,共4页Chinese Journal of Endocrine Surgery

基　　金：河北省重点研发计划项目任务书 (19277767D)。

摘　　要：目的探讨^(125)I粒子治疗甲状腺癌术后剂量学参数与肿瘤体积变化的关系,以期得出甲状腺癌粒子植入术后更精准预测疗效的剂量学参数。方法回顾性分析2008年10月至2021年4月在河北省人民医院肿瘤科行粒子植入治疗的甲状腺癌患者22例,共23个病灶,所有患者术后即刻行剂量验证,得出术后D_(90)(90%靶体积所接受的最小剂量)。术后规律随访,根据患者实际随访时的CT图像计算术后t月肿瘤体积缩小比(R_(t))、初月实际吸收剂量(D_(1m))、初月疗效校正吸收剂量(D_(1e))、初月敏感性校正吸收剂量(D_(1s))。应用SPSS 21.0软件进行数据分析,采用Spearman线性分析将术后D_(90)、D_(1m)、D_(1e)及D_(1s)与R_(t)进行相关性分析,以P<0.05为差异有统计学意义,并进行曲线拟合。结果术后D_(90)、D_(1m)、D_(1e)、D_(1s)、R_(t)均数分别为(129.73±14.22)Gy、(36.95±7.35)Gy、(43.45±11.32)Gy、(41.78±13.39)Gy、(32.00±19.00)%。术后D_(90)、D_(1m)、D_(1e)、D_(1s)与R_(t)为三次函数关系,相关系数分别为0.692、0.551、0.728、0.858,呈显著正相关性(P<0.01)。结论术后剂量学参数D_(90)、D_(1m)、D_(1e)及D_(1s)均可预测甲状腺癌粒子术后疗效,其中D_(1s)预测疗效可能更准确。Objective To investigate the relationship between dosimetric parameters and tumor volume change after ^(125)I implantation for thyroid cancer and obtain better dosimetric parameters that predict the curative effect more accurately.Methods A total of 22 consecutive patients with thyroid cancer(23 targets)who received ^(125)I interstitial brachytherapy in Department of Oncology,Hebei General Hospital were retrospectively analyzed.All the patients received post-operative dose verification,and the D_(90)(Minimum dose received by 90%target volume)was calculated.After a regular follow-up,the tumor volume reduction ratio after t months(R_(t)),actual absorbed dose(D_(1m)),efficacy corrected absorbed dose(D_(1e)),and sensitivity corrected absorbed dose(D_(1s))of the first month were calculated according to the actual follow-up CT images.The statistical test was carried out by SPSS21.0.The Spearman linear analysis was applied to analyze the relationship between D_(90),D_(1m),D_(1e),D_(1s) and R_(t),and the curve fitting was also completed.Results The post-operative D_(90),D_(1m),D_(1e),D_(1s) and R_(t) were(129.73±14.22)Gy,(36.95±7.35)Gy,(43.45±11.32)Gy,(41.78±13.39)Gy,and(32.00±19.00)%,respectively.And the correlation coefficient were 0.692,0.551,0.728,and 0.858,respectively,which showed significant positive relevance between dosimetric parameters and tumor volume change(P<0.01),the curve fitting presented cubic function.Conclusion The post-operative D_(90),D_(1m),D_(1e),and D_(1s) can be predictors for curative effect,and D_(1s) is the best predictor.

关 键 词：碘-125粒子 甲状腺癌 剂量 疗效 近距离治疗 

分 类 号：R653[医药卫生—外科学] R736.1[医药卫生—临床医学]