125I粒子植入联合化学治疗干预晚期结直肠癌肝转移瘤效果

目的 观察¹²⁵I粒子植入联合化学治疗（简称化疗）对晚期结直肠癌肝转移瘤的治疗效果及安全性。方法 对27例晚期结直肠癌肝转移瘤（60个病灶）患者的肝转移瘤病灶行放射性¹²⁵I粒子植入，术后行二线化疗，观察治疗效果、不良反应及预后。结果 60个病灶均顺利植入粒子，剂量分布均匀，共植入粒子1 995枚，平均每个病灶植入粒子（33.41±24.79）枚。术后不良反应轻，予对症处理后均恢复。术后1周肝功能与术前相比无明显差异。以奥沙利铂联合方案化疗6例，伊立替康联合方案21例。化疗3、6个周期后肝转移瘤病灶直径及癌胚抗原（CEA）水平均较术前显著降低（P均<0.001）。中位无进展生存期为8.1个月，中位总生存期为14.6个月。结论 ¹²⁵I粒子植入联合化疗对晚期结直肠癌肝转移瘤安全性好，近期疗效佳。

Effect of 125I seed implantation combined with chemotherapy in treatment of liver metastasis of advanced colorectal cancer

Objective To observe the clinical effect and safety of ¹²⁵I seed implantation combined with chemotherapy in treatment of advanced colorectal cancer with liver metastasis. Methods Totally 27 cases of advanced colorectal cancer with 60 liver metastasis were enrolled. ¹²⁵I seed implantation was performed, followed by second-line chemotherapy. The clinical effect, safety and prognosis of the above treatments were observed. Results Totally 1 995 ¹²⁵I seeds were successfully implanted into 60 liver metastasis([33.41±24.79]seeds in each lesion),and the dose distribution was uniform. Postoperative adverse reactions were mild and recovered after symptomatic treatment. There was no significant difference of liver function before and 1 week after ¹²⁵I seed implantation. Six patients were treated with oxaliplatin combined regimen and 21 with irinotecan combined regimen 1 week after ¹²⁵I seed implantation. At the end of 3 and 6 cycles of chemotherapy, the lesion diameter and carcinoembryonic antigen (CEA) level significantly reduced compared with those before implantation (both P<0.001). The median progression-free survival (PFS) and median overall lifetime (OS) was 8.1 months and 14.6 months, respectively. Conclusion ¹²⁵I seed implantation combined with second-line chemotherapy is safe and effective in near future for treating advanced colorectal cancer patients with liver metastasis.