CT导引下125I粒子植入术治疗恶性肿瘤

目的评价CT导引下瘤体内植入治疗恶性肿瘤的操作方法、可行性、安全性及其疗效。方法7例8个病灶CT导引下穿刺并在瘤体内植入125I粒子,其中恶性肿瘤3例(4个病灶),原发性肿瘤2例,转移性肿瘤2例。其中男性5例,女性2例,年龄42～81岁(平均51.2岁)。在CT导引下将125I粒子植入病灶内,采用治疗计划系统计算布源,125I粒子的放射性活动为22,26,30,33MBq/粒,较大活度的粒子间距为1.5cm,较小活度的粒子间距为1.0cm。结果7例粒子植入均顺利完成,术中无并发症发生,粒子在病灶内的分布与植入前计划基本一致。每个瘤体内植入125I粒子数为10～30(平均14粒)。3例恶性骨肿瘤患者植入术后疼痛均有明显缓解。术后2～5个月复查CT,6个病灶明确缩小,1个病灶内出现坏死组织,1个病灶大小无明显变化。结论CT导引下瘤体内植入125I粒子近距离放射治疗恶性肿瘤是一种安全、有效、可靠的治疗方法。

CT-Guided Percutaneous Permanent 125I Implantation for Patients with Malignant Tumor

Objective To evaluate the methods, feasibility, safety and efficacy of CT-guided iodine-125 implantation for malignant tumors.Methods 8 lesions in 7 consecutive patients with malignant tumor were treated with iodine-125 implantation brachytherapy , of which 3cases (4 lesions) were malignant tumors of bone and 2 cases were primary unrespectable carcinoma and 2 cases were metastases . There were 5 males and 2 females the mean age was 51.2 years (range 42 to 81 years). Under CT guidance , 125I seeds were implanted into malignant tumor according to TPS , The radioactivity quantum were 22,26,30 and 33MBq per granule. Plane implantation technique was adopted with 125I seeds of 1.0-1.5cm.Result The finished implantation were put into the sites of 7 cases , No complications were observed, Contrasted to TPS , 125I seeds were put into correct location . The number of seeds implanted in one lesion was 10 to 30 (mean 14) . Pain relief was obtained in all 3 cases of malignant tumors of bone presenting with pain. Follow-up CT demonstrated that 6 lesions diminished , Necrosis was found in 1 lesions and remaining 1 lesions had no significant change in size. Conclusion CT-guided iondine-125 implantation is a safe , effective and feasible method in treatment of patients with malignant tumor.