| 放射性125I粒子植入治疗原发性肝细胞癌合并静脉癌栓 |
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| 引用本文： | 杜鹏,卢伟,杨剑,蒋富强,杨超,马军朋.放射性125I粒子植入治疗原发性肝细胞癌合并静脉癌栓[J].中国介入影像与治疗学,2019,16(10):585-589. |
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| 作者姓名： | 杜鹏 卢伟 杨剑 蒋富强 杨超 马军朋 |
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| 作者单位： | 中国人民解放军总医院第六医学中心介入医学科 |
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| 基金项目： | 海军总医院创新培育基金（CXPY201718）。 |
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| 摘 要： | 目的探讨CT引导下经皮穿刺放射性~(125)I粒子植入治疗原发性肝细胞癌(HCC)合并静脉癌栓的价值。方法回顾性分析10例原发性HCC合并静脉癌栓患者,其中8例合并门静脉癌栓,2例合并肝静脉癌栓。对静脉癌栓行~(125)I粒子植入治疗,术前通过放射治疗计划系统(TPS)制定治疗计划,术后进行剂量验证。随访评估癌栓治疗效果,计算术后6个月治疗有效率及疾病控制率,对患者进行生存分析,并观察放射性损伤及并发症情况。结果对所有患者均顺利完成粒子植入。随访期间未见癌栓复发,术后6个月治疗有效率为90.00%(9/10),疾病控制率达100%(10/10)。术后患者生存期为8～36个月,术后1年生存率为70.00%,术后2年生存率为40.00%。2例术中出现肝出血、2例术中出现肝区疼痛,2例术后轻度恶心、食欲下降,未发生急晚期放射性损伤及严重并发症。结论 CT引导下经皮穿刺放射性~(125)I粒子植入可安全有效地治疗原发性HCC合并静脉癌栓。
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| 关 键 词： | 癌 肝细胞 放射学 介入性 近距离放射疗法 间质内照射 |
| 收稿时间： | 2019/4/8 0:00:00 |
| 修稿时间： | 2019/7/23 0:00:00 |
Radioactive 125I seed implantation in treatment of vein tumor thrombi in patients with hepatocellular carcinoma |
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| DU Peng,LU Wei,YANG Jian,JIANG Fuqiang,YANG Chao and MA Junpeng.Radioactive 125I seed implantation in treatment of vein tumor thrombi in patients with hepatocellular carcinoma[J].Chinese Journal of Interventional Imaging and Therapy,2019,16(10):585-589. |
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| Authors: | DU Peng LU Wei YANG Jian JIANG Fuqiang YANG Chao and MA Junpeng |
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| Institution: | Department of Interventional Radiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China,Department of Interventional Radiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China,Department of Interventional Radiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China,Department of Interventional Radiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China,Department of Interventional Radiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China and Department of Interventional Radiology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China |
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| Abstract: | Objective To explore the value of CT-guided radioactive 125I seed implantation for treatment of vein tumor thrombi in patients with primary hepatocellular carcinoma (HCC). Methods Data of 10 patients with primary HCC complicated with vein tumor thrombi were analyzed retrospectively. Among them, 8 cases combined with portal vein tumor thrombi and 2 cases combined with hepatic vein tumor thrombi. Radioactive 125I seed implantation for vein tumor thrombi was performed. Treatment planning system (TPS) was used to make preoperative plan, and dose verification was performed immediately after operation. The effective rate and local control rate of cancer thrombi were observed up till 6 months after operation. Survival analysis was performed, and intraoperative and postoperative complications were analyzed. Results 125I seed implantation was successfully completed in all patients. No recurrence of tumor thrombus occurred during post-operation follow-up. The effective rate was 90.00% (9/10), and the disease control rate reached 100% (10/10) 6 months after operation. Postoperative overall survival was 8-36 months. The 1-year and 2-year survival rate was 70.00% and 40.00%, respectively. Intraoperative hepatic hemorrhage and hepatic pain were observed each in 2 cases, while postoperative mild nausea and decreased appetite occurred in 2 cases. No acute and late radiation damage and serious complications occurred. Conclusion CT-guided radioactive 125I seed implantation is safe and effective for treatment of vein tumor thrombi in patients with primary HCC. |
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| Keywords: | carcinoma hepatocellular radiology interventional brachytherapy interstitial irradiation |
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