^(125)I粒子植入治疗复发性恶性肿瘤31例

Radiactive seed ^(125)I implantaton in treating relapsed malignant tumors for 31 cases

目的:探讨125I粒子植入治疗复发性恶性肿瘤的疗效及安全性。方法:31例复发性恶性肿瘤患者,男22例,女9例,年龄19岁-76岁,平均51岁,其中脑胶质瘤1例,鼻咽癌4例,鼻窦癌2例,口咽癌2例,食道癌3例,肺癌5例,乳腺癌1例,肝癌4例,直肠癌3例,宫颈癌1例,骨肉瘤3例,纤维肉瘤2例,31例共36个病灶。在CT或B超引导下将125I粒子植入肿瘤病灶内,采用放射性粒子治疗计划系统(TPS)设计布源,将放射性活度为23.31MBq-29.97MBq的125I粒子按10mm层间距植入。结果:31例36个病灶,完全缓解(CR)8个,部分缓解18个,总有效率72.2%。术中11例出现少量渗血;术后出现胸背痛1例,1例出现少量气胸(肺压缩小于30%),保守治疗后恢复;食道气道瘘1例。结论:125I粒子植入作为常规放化疗治疗复发性恶性肿瘤的一种补充治疗手段,局部控制率高,创伤小,安全性好。

Objective： To investigate the effect and safety of the radiative seed 125↑ I implantation in treating relapsed malignant tumors. Methods ：Thirty one patients （ male 23, femal 9, age 19 -76, median age 51 ） ,1 case gliomas, 4 cases nasopharynx cancer,2 cases nasosinus cancer,3 cases esophagus cancer,5 cases lung cancer, 1 case breast cancer,4 cases liver cancer,3 cases rectal cancer, 1 case had cervix cancer,3 cases osteosarcoma,2 cases fiberosarcoma ,31 patients totally with 36 metastatic lesions Under CT or ultrasound guidance, 125↑I seeds （ 23.31 MBq - 29, 97MBq ） were implantated into metastatic lesions at a distance of 10 mm according to TPS. Results ：Among 36 lesions in 31 cases,8 cases obtained CR, 18 PR. The response rate was 72.2%. The side effect occurred during the procedure including effusions in 11 cases, after the procedure chest pain in 1 case ,pheumothorax in 1 case with lung compressed less than 30 percent and broncho -esophageal fistula in 1 case. Conclusion ：Radiative seed 125↑I implantation is the additional way of normal radiotherapy in treating relapsed malignant tumors with good clinical effect ,less damage, and great safety.