摘要
目的：探讨在MSCT引导下经皮穿刺125Ｉ粒子组织间植入治疗恶性肿瘤的安全性、疗效及应用价值。方法：70例恶性肿瘤76个病灶，瘤体直径2.5～12.0cm，平均6.5cm。根据粒子植入术前14天MSCT图像，采用治疗计划系统（TPS）制定粒子植入计划，按计划在MSCT引导下经皮穿刺准确植入125Ｉ粒子。植入后即刻及术后2～8个月CT复查观察粒子在瘤体内的分布、有无并发症发生及疗效。结果：70例恶性肿瘤粒子植入均顺利完成，单个瘤体内植入粒子数分别为10～90粒（平均45粒）。70例粒子植入患者中66例71个病灶内粒子分布满意，4例5个病灶粒子分布欠均匀，4例5个病灶分别于术后4～8周对肿瘤区进行补充粒子植入。70例恶性肿瘤76个病灶，完全缓解（CR）5个；部分缓解（PR）45个；无变化（NC）15个；进展（PD）11个。总有效率65.79％（50/76）。仅在肺癌的植入粒子治疗后，15例中有4例出现少量气胸，保守治疗后痊愈。未见其他严重并发症和治疗相关的放射性损伤。结论：在MSCT引导下经皮穿刺125Ｉ粒子组织间植入治疗恶性肿瘤是一种简便易行、安全有效的微创治疗手段。
Abstract
Objective: To evaluate the safety and efficacy of percutaneous MSCT guided interstitial 125I seed implantation treatment for refractory malignant tumor. Methods: Seventy-six lesions(diameter 2.5~12.0cm, mean 6.5cm) in 70 refractory malignant tumor patients underwent percutaneous MSCT guided intratumoral 125I seed implantation. Treatment plan system(TPS) was adopted based on CT imaging 14 days before the procedure. The distribution of 125I seed, complications and efficacy were observed immediately after and 2~8 months after the procedure. Results: The procedure of intratumoral 125I seed implantation in 76 malignant tumors was successful. Ten to ninety particles(mean 45) of 125I seeds were implanted into a single tumor. The distribution of seeds in 71 malignant tumors in 66 patients was satisfactory while the distribution of 125I seeds in 5 malignant tumors of the other 4 cases was not uniform, and the latter 5 malignant tumors of 4 cases were carried out supplementary 125I seed implantation in the tumor cool area 4~8 weeks after the procedure. The clinical CR and PR were achieved in 5 and 45 lesions respectively, with an overall response rate of 65.79％（50/76）. Pneumothorax occurred in 4 cases with lung cancer. No acute complications and treatment related radiation damages occurred in the other cases. Conclusions: The MSCT guided percutaneous intratumoral 125I seed implantation treatment for refractory malignancies is a safe and effective method.
关键词
肿瘤 /
碘放射性同位素 /
体层摄影术 /
螺旋计算机
Key words
Neoplasms /
Iodine radioisotopes /
Tomography /
spiral computed
高建华;赵相胜;商健彪.
MSCT引导下125Ｉ粒子植入治疗恶性肿瘤的应用价值[J]. 中国临床医学影像杂志. 2008, 19(3): 198-202
GAO Jian-hua;ZHAO Xiang-sheng;SHANG Jian-biao.
Interstitial 125Ｉ seed implantation in the treatment for refractory malignant tumor under the guidance of MSCT[J]. Journal of China Clinic Medical Imaging. 2008, 19(3): 198-202
中图分类号：
Ｒ73
Ｒ817.8
Ｒ814.42
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