术中组织间植入^(125)I粒子治疗肝恶性肿瘤

Interstitial ^(125)I implants for liver malignancies

目的评价术中组织间植入125I粒子治疗中晚期肝恶性肿瘤及预防肝癌局部复发的作用。方法根据三维治疗计划系统(TPS),采用125I粒子术中植入不可切除的肝肿瘤或肿瘤切除后的切缘组织,对肿瘤及癌旁组织持续、精确、适形的放射治疗。结果本组15例中14例为肿瘤切除后切缘肝组织预防性粒子植入,1例为肿瘤未切除行瘤体内粒子植入。术后均无并发症发生。随访2～12个月,全部存活,未见肿瘤局部复发。瘤体内粒子植入者,术后随访2月,瘤体缩小。结论术中组织间植入125I粒子具有创伤小,安全,操作简便,疗效确切等优点,对无法切除或行姑息行切除者,可降低术后复发、提高生存率。

Objective To evaluate the effect of interstitial ~125 I implants on treatment and reducing tumor local recurrence in patients with liver malignancies.Methods ~125 I seeds calculated by “treatment plan system” (TPS) were intraoperatively implanted into the unresectable liver cancer or the margins of the liver after tumor resection,in order to treat the tumor and residual tissue with permanent accurate and brachytherapeutic radiation.Results ~125 I seeds were implanted into the resection margins of the liver in 14 patients and into the unresected tumor in one.All of the 15 patients had a good recovery without any complications postoperatively.The 15 cases survived after follow-up for 2-12 months.There was no any tumor recurrence in the patients subject to prophylactic ~125 I seeds implants.The tumor was reduced by implanting ~125 I seeds in one patient without tumor resection after 2 monthes of the treatment.Conclusion ~125 I implantation can be performed safely and conveniently with a minimal invasion and certain effect for the patients with unresectable liver tumor or incurative resection of tumor to reduse the postoperative recurrence.