CT引导下放射性125I粒子植入治疗难治性肝转移癌的临床观察

摘要

目的 评价CT引导下放射性125Ⅰ粒子植入近距离放射治疗难治性肝转移癌的临床价值.方法 2010年1月至2012年1月在CT引导下实施1251粒子植入治疗的40例难治性肝转移癌患者,共有可测量病灶94个.评价临床疗效、术后并发症及不良反应.结果 至植入术后6个月时,94个病灶中获完全缓解(CR)32个,部分缓解(PR) 48个,稳定(SD)9个,进展(PD)5个,有效率(RR)为85.1％.术后随访时间为4～31个月,平均13个月.至随访结束时,1年生存率为75.0％.无手术相关的严重并发症及3～4级不良反应.结论 CT引导下125Ⅰ粒子植入治疗的疗效确切、毒副反应少,可作为难治性肝转移癌新的有效治疗手段.%Objective To evaluate the clinical value of CT-guided radioactive 125Ⅰ seed implantation brachytherapy for refractory metastatic liver cancer.Methods Forty refractory metastatic liver cancer patients with 94 measurable metastatic foci were treated under the CT-guided with the 125Ⅰ radioactivity seed interstitial brachytherapy from January 2010 to January 2012.The clinical effects,postoperative complications and adverse reactions were evaluated.Results After operation for 6 months,of all the 94 measurable metastatic foci,32 foci got complete response (CR),partial response (CR) was observed in 48 foci,stable disease(SD) in 9 foci and progressive disease (PD) in 5 foci.The response rate (RR) was 85.1％.The follow-up ranged from 4 to 31 months (average 13 months).At the end of the follow-up period,1-year survival rate was 75.0％.No serious operative or postoperative complications and grade 3-4 adverse effects occurred.Conclusion CT-guided 125Ⅰ seed implantation brachytherapy showed good clinical effects but fewer side effects.It can be used as a new treatment option for patients with refractory metastatic liver cancer.