CT导向下125I粒子组织间植入治疗难治性直肠癌盆腔复发

摘要

目的 探讨CT导向下125I粒子组织间植入治疗难治性直肠癌盆腔复发的疗效和安全性.方法 回顾分析2010年4-9月行CT导向下125I粒子组织间植入的直肠癌术后化放疗后盆腔复发病例11例,分别对比术前与术后2、6个月临床症状及肿瘤大小变化、生活质鼍(QOL)评分,并观察并发症情况,随访期6个月.结果 术后2、6个月症状缓解率分别为100%(11/11)和90.9%(10/11);肿瘤缓解率分别为90.9%(10/11)和81.8%(9/11);术后2、6个月QOL评分分别为(56.0±3.66)分及(54.4±5.41)分,较术前QOL评分(42.5±6.93)分提高,差异有统计学意义(P<0.05);均无严重并发症发生.结论 CT导向下125I粒子组织间植入治疗难治性直肠癌盆腔复发的近期效果好,对于受组织剂量限制难以再行外放疗的病例也同样安全、有效.%Objective To evaluate the therapeutic effect and safety of CT-guided interstitial 125Ⅰ seed implantation in treating intractable pelvic recurrence of rectal carcinomas. Methods During the period from April 2010 to September 2010 CT-guided interstitial 125Ⅰ seed implantation was carried out in 11 patients with pelvic recurrence of rectal caicinoma which developed after the patients had received comprehensive treatments such as surgical resection. chemotherapy and/or radiotherapy. The clinical data were retrospectively analyzed. The clinical symptoms. the tumor size and the quality of life (QOL) before the treatment and at two and six months after the treatment were recorded. and the complications were observed.The results were compared. All the patients were followed up for six months. Results At two and six months after the treatment. the improvement rate of the clinical symptoms was 100.0％ (11/11) and 90.9％ (10/11) respectively, while the effective reduction of the tumor size was 90.9％ (10/11) and 81.8％ (9/11) respectively. At two and six months after the treatment the QOL score was (56.0 ± 3.66) and (54.4 ± 5.41) respectively, both of which were higher than the QOL score determined before the treatment (42.5 ±6.93) ,the difference between them was statistically significant (P ＜ 0.05). No serious complications occurred in all cases. Conclusion For intractable pelvic recurrence of rectal carcinomas, CT-guidecl interstitial 125Ⅰ seed implantation has satisfactory short-term effect. This treatment is also quite safe and effective for patients who are unbearable to external radiation therapy due to the tissue dose restriction. (J Intervent Racliol, 2011, 20 :709-712)