消融或联合125I粒子植入术治疗肾癌11例报告

背景与目的:射频多极针消融和近距离放疗近年来被广泛用于治疗肝癌和前列腺癌等实体肿瘤。本研究探讨用射频多极针消融或联合125I粒子植入术治疗肾癌患者的可行性。方法:2000年6月至2004年2月,采用射频多极针消融或联合植入放射性125I粒子治疗原发性肾癌患者11例,共13个肿瘤结节。其中孤立肾6例,肾癌合并对侧输尿管结石导致肾功能严重受损2例,双侧肾肿瘤1例,高龄患者不能耐受手术2例。对这13个肿瘤结节,分别采用开放手术、单纯消融、消融联合肿瘤周边植入放射性125I钛壳粒子进行治疗。结果:11例患者,术后随访6～46个月,平均27个月。1例术后4个月死于心肌梗塞;2例分别于术后7、11个月肿瘤复发,再次消融;1例因尿毒症间断透析治疗;7例患者肾功能正常。结论:消融或125I粒子植入术是治疗孤立肾、双肾肿瘤和高危不能耐受手术患者的一种可供选择的方法。

Treating renal carcinoma with ablation or ablation combined with 125I seed implantation: a report of eleven cases

BACKGROUND & OBJECTIVE: Recently, multi-needles radiofrequency ablation and brachyradiotherapy have been used to treat some solid tumors, such as liver cancer and prostate cancer. This study was to explore the feasibility and efficacy of radiofrequency ablation or ablation combined with 125I seed implantation on treating renal carcinoma. METHODS: From Jun. 2000 to Feb. 2004, 11 patients with a total of 13 renal carcinoma lesions were treated with ablation or ablation combined with 125I seed implantation, including 6 cases of renal carcinoma of solitary kidney, 2 cases of renal carcinoma combined with contralateral renal atrophy resulted from ureteric stone, 1 case of bilateral tumor, and 2 cases with general conditions contraindicated to surgery. Of the 13 lesions, 1 was resected by open operation, 6 were treated with multi-needles radiofrequency ablation, and 6 were treated with ablation and simultaneous 125I seed implantation around tumor margin. RESULTS: The patients were followed-up for 6-46 months (mean 27 months). One patient died of cardiac muscle infarction 4 months after operation. Of the 10 alive patients, 2 with recurrent tumors 7 months and 13 months after operation were treated with ablation again, 1 with postoperative uremia was treated with intermittent peritoneal dialysis, the rest 7 had normal renal function. CONCLUSION: Multi-needles radiofrequency ablation or ablation combined with 125I seed implantation would be an option in the treatment for patients with renal carcinoma of solitary kidney or bilateral kidney lesions, or for patients can't suffer from surgery.