Background This study evaluated the clinical application of CT guided ^125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods The ten patients （9 males and 1 f...Background This study evaluated the clinical application of CT guided ^125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods The ten patients （9 males and 1 female, aged from 36 to 72 years） with portal vein tumor thrombus accompanying hepatocellular carcinoma had been treated with comprehensive therapy including surgery, transcatheter arterial chemoembolization, radiotherapy ablation, microwave ablation or percutaneous ethanol injection. The average diameter of each tumor thrombus was 21.5 mm × 30.5 mm. Seeds of 30 MBq ^125I were implanted 5 mm apart within the portal vein tumor thrombus. The follow-up after 4 months included enhanced spiral CT. Results CT screening of the tumours indicated that 4 out of 10 patients showed complete response to the therapy, 5 partial response and 1 stable disease. Adverse effects included aggravated abdominal dropsy and temporarily increased transaminase, which were controlled by medical management. Severe complications such as haemorrhage, biliary fistula hepatic abscess, pancreatic fistula and hepatic function failure were not observed. Implanted seeds migrated to lung and left hepatic lobe in 1 case. Conclusion CT guided implantation of ^125iodine seeds, can effectively treat portal vein tumor thrombus accompanying hepatocellular carcinoma with minimal damage and few complications.展开更多
BACKGROUND Pancreatic cancer is one of the common malignant tumors of the digestive system,and radical resection is the first choice of treatment for pancreatic cancer.If patients with locally advanced pancreatic canc...BACKGROUND Pancreatic cancer is one of the common malignant tumors of the digestive system,and radical resection is the first choice of treatment for pancreatic cancer.If patients with locally advanced pancreatic cancer cannot be treated in time and effectively,their disease often develops rapidly and their survival period is very short.AIM To evaluate the therapeutic effect of ^125I seed implantation in patients with locally advanced pancreatic cancer.METHODS The demographics and perioperative outcomes of a consecutive series of patients who underwent ^125I seed implantation to treat locally advanced pancreatic cancer between January 1,2017 and June 30,2019 were retrospectively analyzed.According to the results of preoperative computed tomography or magnetic resonance imaging,the treatment planning system was used to determine the area and number of ^125I seeds implanted.During the operation,^125I seeds were implanted into the tumor under the guidance of intraoperative ultrasound,with a spacing of 1.5 cm and a row spacing of 1.5 cm.For patients with obstructive jaundice and digestive tract obstruction,choledochojejunostomy and gastroenterostomy were performed simultaneously.After operation,the patients were divided into a non-chemotherapy group and a chemotherapy group that received gemcitabine combined with albumin-bound paclitaxel treatment.RESULTS Among the 50 patients,there were 29 males and 21 females,with a mean age of 56.9±9.8 years.The main reason for the failure of radical resection was superior mesenteric artery invasion(37,74%),followed by superior mesenteric vein invasion(33,66%).Twenty-one(62%)patients underwent palliative surgery and postoperative pain relief occurred in 40(80%)patients.The estimated blood loss in operation was 107.4±115.3 mL and none of the patient received blood transfusion.The postoperative hospital stay was 7.5±4.2 d;one patient had biliary fistula and three had pancreatic fistula,all of whom recovered after conservative treatment.After operation,26 patients received chemoth展开更多
目的探讨碘-125(^(125)I)放射性粒籽植入治疗过程中可能存在的放射性职业病危害因素及辐射水平,探讨关键控制技术。方法以5家开展^(125)I粒籽植入治疗项目的医疗机构为研究对象,采用放射卫生学现场调查、工作场所辐射防护水平检测、人...目的探讨碘-125(^(125)I)放射性粒籽植入治疗过程中可能存在的放射性职业病危害因素及辐射水平,探讨关键控制技术。方法以5家开展^(125)I粒籽植入治疗项目的医疗机构为研究对象,采用放射卫生学现场调查、工作场所辐射防护水平检测、人员个人剂量监测等方法,调查粒籽植入涉源工作场所及相关人员的辐射水平;结合源项分析及放射卫生管理经验,根据危害分析与关键控制点(HACCP)的原理,探讨^(125)I粒籽植入治疗过程的关键控制点。结果不同涉源场所中粒籽植入源运输包装、粒籽植入治疗室和专用病房工作场所各关注点的周围剂量当量率为本底~1.80μSv/h(病房门处),均小于2.5μSv/h;35名放射工作人员全年个人剂量监测结果为0.20~1.80 m Sv,平均为0.42m Sv。结论不同涉源场所的辐射水平及人员的受照剂量均符合国家标准限值的要求;应根据关键控制措施,对^(125)I放射性粒籽植入治疗过程的关键环节予以控制。展开更多
文摘Background This study evaluated the clinical application of CT guided ^125iodine implantation in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods The ten patients （9 males and 1 female, aged from 36 to 72 years） with portal vein tumor thrombus accompanying hepatocellular carcinoma had been treated with comprehensive therapy including surgery, transcatheter arterial chemoembolization, radiotherapy ablation, microwave ablation or percutaneous ethanol injection. The average diameter of each tumor thrombus was 21.5 mm × 30.5 mm. Seeds of 30 MBq ^125I were implanted 5 mm apart within the portal vein tumor thrombus. The follow-up after 4 months included enhanced spiral CT. Results CT screening of the tumours indicated that 4 out of 10 patients showed complete response to the therapy, 5 partial response and 1 stable disease. Adverse effects included aggravated abdominal dropsy and temporarily increased transaminase, which were controlled by medical management. Severe complications such as haemorrhage, biliary fistula hepatic abscess, pancreatic fistula and hepatic function failure were not observed. Implanted seeds migrated to lung and left hepatic lobe in 1 case. Conclusion CT guided implantation of ^125iodine seeds, can effectively treat portal vein tumor thrombus accompanying hepatocellular carcinoma with minimal damage and few complications.
文摘BACKGROUND Pancreatic cancer is one of the common malignant tumors of the digestive system,and radical resection is the first choice of treatment for pancreatic cancer.If patients with locally advanced pancreatic cancer cannot be treated in time and effectively,their disease often develops rapidly and their survival period is very short.AIM To evaluate the therapeutic effect of ^125I seed implantation in patients with locally advanced pancreatic cancer.METHODS The demographics and perioperative outcomes of a consecutive series of patients who underwent ^125I seed implantation to treat locally advanced pancreatic cancer between January 1,2017 and June 30,2019 were retrospectively analyzed.According to the results of preoperative computed tomography or magnetic resonance imaging,the treatment planning system was used to determine the area and number of ^125I seeds implanted.During the operation,^125I seeds were implanted into the tumor under the guidance of intraoperative ultrasound,with a spacing of 1.5 cm and a row spacing of 1.5 cm.For patients with obstructive jaundice and digestive tract obstruction,choledochojejunostomy and gastroenterostomy were performed simultaneously.After operation,the patients were divided into a non-chemotherapy group and a chemotherapy group that received gemcitabine combined with albumin-bound paclitaxel treatment.RESULTS Among the 50 patients,there were 29 males and 21 females,with a mean age of 56.9±9.8 years.The main reason for the failure of radical resection was superior mesenteric artery invasion(37,74%),followed by superior mesenteric vein invasion(33,66%).Twenty-one(62%)patients underwent palliative surgery and postoperative pain relief occurred in 40(80%)patients.The estimated blood loss in operation was 107.4±115.3 mL and none of the patient received blood transfusion.The postoperative hospital stay was 7.5±4.2 d;one patient had biliary fistula and three had pancreatic fistula,all of whom recovered after conservative treatment.After operation,26 patients received chemoth
文摘目的探讨碘-125(^(125)I)放射性粒籽植入治疗过程中可能存在的放射性职业病危害因素及辐射水平,探讨关键控制技术。方法以5家开展^(125)I粒籽植入治疗项目的医疗机构为研究对象,采用放射卫生学现场调查、工作场所辐射防护水平检测、人员个人剂量监测等方法,调查粒籽植入涉源工作场所及相关人员的辐射水平;结合源项分析及放射卫生管理经验,根据危害分析与关键控制点(HACCP)的原理,探讨^(125)I粒籽植入治疗过程的关键控制点。结果不同涉源场所中粒籽植入源运输包装、粒籽植入治疗室和专用病房工作场所各关注点的周围剂量当量率为本底~1.80μSv/h(病房门处),均小于2.5μSv/h;35名放射工作人员全年个人剂量监测结果为0.20~1.80 m Sv,平均为0.42m Sv。结论不同涉源场所的辐射水平及人员的受照剂量均符合国家标准限值的要求;应根据关键控制措施,对^(125)I放射性粒籽植入治疗过程的关键环节予以控制。
