CT引导下125I放射性粒子植入治疗原发性肝细胞癌伴门静脉癌栓

摘要

Objective To assess the clinical values of CT-guided iodine-125 seed implantation for portal vein tumor thrombus (PVTT) due to hepatocellular carcinoma (HCC). Methods According to the treatment planning system (TPS), CT-guided iodine-125 seed therapies were performed on 47 HCC patients with PVTT with the prescription dose of 100120 Gy after TACE. The changes of sizes of PVTT, liver function and alpha fetoprotein of patients before and after the therapeutic modality were observed. Results Complete remission was not observed, while partial remission was observed in 29 patients. The effective rate was 61.70％ (29/47). The sizes of PVTT significantly reduced (P＜0. 05) after treatment. The 1-year and 2-year survival rates was 53.45％ and 36. 75％, respectively, with CT-guided iodine-125 seed implantation therapy. The mean survival period was (14±2) months. Conclusion CT-guided iodine-125 seed implantation can markedly improve the therapeutic effect with the advantages of minimally invasion, rapid recovery and limited complications.%目的 探讨CT引导下125I放射性粒子植入术治疗原发性肝细胞癌(HCC)合并门静脉癌栓(PVTT)的疗效.方法 根据放射性粒子植入计划系统(TPS系统),通过CT引导对47例HCC合并PVTT患者于TACE后植入125I放射性粒子,癌栓处方剂量100～120 Gy,对比治疗前后癌栓长径、肝功能、AFP的变化.结果 完全缓解无,部分缓解29例,总有效率为61.70%(29/47);术后癌栓长径明显小于术前(P<0.05).接受125I放射性粒子植入治疗后,47例患者1年、2年生存率分别为53.45%、36.75%,平均生存期为(14±2)个月.结论 CT引导下125I放射性粒子植入术治疗HCC伴PVTT可明显提高疗效,创伤小、恢复快、并发症少.