125I粒子植入治疗晚期恶性肿瘤的疗效

目的 评价植入125I放射性粒子治疗晚期恶性肿瘤的疗效.方法 2006年6月至2008年11月本院肿瘤患者15例24个病灶(原发肿瘤11个病灶,转移瘤13个病灶),按治疗计划在CT引导下用植入枪穿刺植入125I放射性粒子,其中3例胆管壶腹部癌患者在胆管支架植入术后经皮肝穿刺置管引流术(PTCD),粒子置于引流管并随其末端至肿瘤梗阻部位,3个月后拔除引流管.植入术后观察疗效和并发症.结果 接受粒子植入的肿瘤病灶治疗有效率为70.8%(17/24),完全缓解(CR)5个病灶(20.8%),部分缓解(PR)12个病灶(50.0%);卡式评分(KPS,中位评分70分)高于治疗前(50分);疼痛缓解率90%(9/10);中位总生存期12.0个月.3例患者分别出现气胸、胆漏和粒子游走.结论 125I放射性粒子植入治疗晚期肿瘤患者,可减轻症状,改善生活质量.

Efficacy of iodine-125 seed implantation in treating advanced cancer

Objective To evaluate the efficacy of 125I radioactive seeds implantation in treating advanced cancers. Methods Fifteen patients with 24 lesions in total ( 11 primary lesions and 13 metastatic lesions), who stayed in our hospital during June 2006 and November 2008, underwent 125I radioactive seeds implantation under CT guidance. Three patients with carcinoma of ampulla of bile ducts received percutaneous transhepatic cholangiodrainage (PTCD) after biliary stenting, with the 125I seeds input in and along the drainage tube to reach location of tumor obstruction. Extubation was performed three months later.Therapeutic efficacy and complications were observed after implantation. Results Overall response to 125I seed implantation was found in 70.8% (17/24) of the lesions, with complete remission (CR) in 5 lesions (20.8%) and partial remission (PR) in 12 (50.0%). Karnofsky performance status (KPS, median score 70)was higher than that pre-treatment (score 50). Pain relief was achieved in 90% (9/10) of the patients. The overall median survival length was 12.0 months. Pneumothorax, bile leakage and seeds migration were observed in 3 patients. Conclusion 125I radioactive seeds implantation may relieve symptoms and improve quality of life in advanced cancer patients.