^(125)Ⅰ粒子植入治疗肺转移癌的局部疗效分析  

Analysis of the local efficacy of ^(125)I particle implantation for pulmonary metastases

作　　者：曹国辉 王泽阳[1] 徐克 刘晓丽[1] 赵金鑫[1] 刘泽洲[1] 王娟[1] 张宏涛[1] CAO Guohui;WANG Zeyang;XU Ke;LIU Xiaoli;ZHAO Jinxin;LIU Zezhou;WANG Juan;ZHANG Hongtao(Hebei Provincial Tumor Radioactive Seeds Implantation Diagnosis and Treatment Center,Hebei Provincial Radioactive Seeds Brachytherapy Institute,SectionΙ,Department of Oncology,Hebei Provincial People's Hospital,Shijiazhuang,Hebei Provincial 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,河北石家庄050051

出　　处：《介入放射学杂志》2023年第6期598-601,共4页Journal of Interventional Radiology

摘　　要：目的探讨CT引导下放射性125Ⅰ粒子植入治疗肺转移癌的局部有效率及预后影响因素。方法选择2017年1月至2021年3月在河北省人民医院接受^(125)Ⅰ粒子植入治疗的肺转移癌患者37例。采用χ^(2)检验对患者临床疗效影响因素进行分析。通过受试者工作特征曲线(ROC)获得最佳术后90%大体肿瘤体积所接受的剂量(D90)界值。对各临床病理因素进行logistic单因素分析,采用二元logistics进行多因素分析。结果粒子术后6个月总有效率为75.68%(28/37)。D90≥131.38 Gy组与D90<131.38 Gy组近期有效率分别为100.00%(19/19)、50.00%(9/18),差异有统计学意义(χ^(2)=12.55,P=0.0004)。单因素分析结果显示,肿瘤大小(χ^(2)=14.24,P=0.0002)、D90(χ^(2)=12.55,P=0.0004)是粒子术后局部疗效的影响因素。二元logistics分析未发现有统计学意义的独立影响因素。术中发生气胸19例(51.4%),肺内出血2例,未发现明显疼痛、肿瘤种植转移、空气栓塞、放射性肺炎等并发症。结论具有安全的局部控制效果,将D90界限控制在131.38 Gy以上时能够达到较好的肿瘤局部有效率,肿瘤大小和D90是粒子术后有效性的影响因素。Objective To investigate the local efficacy of ^(125)I particle implantation in treating pulmonary metastases,and to analyze the influencing factors for prognosis.Methods A total of 37 patients with lung metastasis,who received ^(125)I seed implantation at Hebei Provincial People's Hospital of China between January 2017 and March 2021,were collected.By using group t-testing the dose relationship between the efficacy groups was analyzed,and the factors influencing patient’s clinical efficacy were analyzed by usingχ^(2)inspection.Through analysis of receiver operating characteristic(ROC)curve,the optimal cut-off value of postoperative dose delivered to 90%gross tumor volume(D90)was determined.Logistic univariate analysis was performed for each clinicopathological factor,and binary logistics was used to make multivariate analysis.Results The postoperative 6-month total effective rate was 75.68%(28/37).The short-term effective rates in the D90≥131.38 Gy group and D90<131.38Gy group were 100.00%(19/19)and 50.00%(9/18)respectively,the difference was statistically significant(χ^(2)=12.55,P=0.0004).Univariate analysis showed that tumor size(χ^(2)=14.24,P=0.0002)and postoperative D90(χ^(2)=12.55,P=0.0004)were the influencing factors for local efficacy after ^(125)I seed implantation.Binary logistic analysis revealed that no statistically significant independent influencing factors were found.Intraoperative complications included pneumothorax(n=19,51.4%)and intrapulmonary hemorrhage(n=2).No obvious pain,tumor implantation and metastasis,air embolism,radiation pneumonia,etc.were observed.Conclusion For the treatment of pulmonary metastases,^(125)I seed implantation has a safe and local control effect.When the D90 is controlled above 131.38 Gy,a better tumor local response rate can be obtained.Tumor size and D90 are the influencing factors for the effectiveness of 125I seed implantation.

关 键 词：^(125)Ⅰ粒子 肺转移癌 局部疗效 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]