摘要
目的评价外照射后复发的恶性肿瘤行CT导引下瘤体内125I粒子植入治疗的可行性、安全性及疗效。资料与方法2001年12月至2004年12月,14例外照射后局部复发的恶性肿瘤行CT导引下瘤体内125I粒子植入,其中原发肿瘤8例,转移瘤6例(11个病灶),病灶的平均直径为3.25cm。依据粒子植入术前CT图像应用计算机治疗计划系统制定粒子植入计划,按治疗计划在CT导引下穿刺植入125I粒子。植入125I粒子数为9~48粒(中位数为28粒)。植入术后立即CT扫描及术后2~6个月CT扫描观察粒子在瘤体内的分布、有无并发症发生及疗效。结果14例粒子植入均顺利完成,瘤体内粒子分布满意,其中1例植入术后有2粒粒子脱落到体外,未见急性并发症和治疗相关的放射损伤。4例疼痛患者粒子植入术后疼痛均有明显减轻。14例19个病灶粒子植入后完全缓解(CR)5个,部分缓解(PR)9个,无变化(NC)4个,进展(PD)1个,近期总有效率73.7%。结论对于外照射后复发的恶性肿瘤CT导引下瘤体内125I粒子植入近距离放射治疗是一种安全、可行的治疗方法,近期肿瘤局部控制率满意,远期疗效有待大组病例进一步观察。
Objective To evaluate the feasibility, safety and efficacy of CT guided permanent iodine-125 implantation in patients with local recurrent malignant tumor after external beam radiation. Materials and Methods 14 patients with recurrent malignant tumor after external beam radiation were treated with CT-guided iedine-125 permanent implantation hrachytherapy, of which 8 cases were primary unresectable carcinoma and remaining 6 cases were metastases, The mean lesion diameter of perimplant was 3.25 cm. Based on the CT imaging before the implantation, a computer based treatment planning system was used to determine the optimal seed distribution. Subsequently CT-guided needle placement and seed implantation were carried out. The number of seeds implanted in lesion was 9 to 44 （median 28）. Pestimplant CT scans were performed immediately and seed distribution, complication and curative effect were evaluated 2 to 6 months after the implantation in all cases. Results CT-guided iodine 125 permanent implantation was accomplished smoothly in all cases, seeds were placed properly and accurately. 2 seeds migration were occurred in 1 case, no acute complications and injury related to the radiotherapy were observed. Pain relief was obtained in 4 cases （100%） presenting with pain. Among 19 lesions in 14 cases, 5 cases were completely relieved （CR）, partly relieved in 9 cases （PR）, no change in 4 cases （NC） and progressed in 1 cases （PD）. Recent effective rate was 73.7 %. Conclusion CT-guided iodine-125 permanent implantation is a feasible, effective, safe for locally, recurrent malignant tumor after external beam radiation. The local control is promising, long term effective need series of patients to evaluate.
出处
《临床放射学杂志》
CSCD
北大核心
2006年第3期269-272,共4页
Journal of Clinical Radiology
