摘要
目的探讨CT导向下125Ⅰ粒子植入治疗技术在治疗直肠癌术后局部复发中的意义。方法21例直肠癌术后局部复发患者，男12例，女9例，年龄35～69岁，中位年龄47岁。所有患者均为直肠癌Mile术后局部复发病例。肿瘤最大长径为3．4～6．4cm，平均4．2cm。患者主要临床症状为臀部或会阴部疼痛，按主诉疼痛程度分级法（VRS法）分级，轻度疼痛4例，中度疼痛6例，重度疼痛11例。采用CT导向下125Ⅰ放射性粒子植入，粒子植入之前采用TPS模拟布源或遵循Halarism的125Ⅰ经验公式，求出术中所需125Ⅰ粒子的总活度及算出治疗粒子的数量。在CT扫描下确定穿刺的部位，注意避开重要血管及神经。穿刺到位后应回抽无血液回流后每隔0．5-0．7cm放置一颗125Ⅰ粒子。结果疼痛完全缓解率76％（16／21），部分缓解率19％（4／21），轻度缓解率5％（1／21），总有效率100％。症状缓解持续时间最长16个月，最短7个月，平均症状缓解持续时间11个月。影像学评价完全缓解（CR）16例，部分缓解（PR）3例，稳定（NC）2例。结论CT导向下125Ⅰ粒子植入是治疗直肠癌术后局部复发的有效方法。
Objective To explore the clinical value of CT guided 125I seeds implantation in the treatment of local recurrent rectal cancer after surgery resection. Methods Twenty-one patients with local recurrent rectal cancer after surgery, 12 males and 9 females, aged 47 （35 -69）, with the longest diameter of 4. 2 cm （3.4-6. 4 cm）, were treated by CT guided 125I radioactive seeds implantation according to treatment planning system （TPS） or Halarism＇s experienced function： mCi = Da x 5. Totally, 506 seeds, 24. 1 for one patient on average, were implanted. All the patients received PET-CT scan 3 months after the treatment and were followed up for 12. 5 months （7 - 22 months）. Results Complete remission, partial remission, and no change were seen in 16, 3, and 2 patients respectively. All patients survived. Conclusion CT guided 125I seeds implantation is an effective methods in the treatment of local recurrent rectal cancer after surgery resection.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第19期1335-1338,共4页
National Medical Journal of China
