^(90)Y、^(32)P-GTMS 介入治疗恶性肿瘤的实验研究与初步临床应用

THE EXPERIMENT AND PRIMARY CLINICAL PRACTICE OF 90Y,32PGTMS INTERVENING TREATMENT OF MALIGNANT TUMOUR

采用介入治疗法，将９０Ｙ－ＧＴＭＳ和３２Ｐ－ＧＴＭＳ直接注入癌性肿块中，以达到杀灭癌细胞、抑制肿瘤生长、延长恶性肿瘤患者生存期的目的。在荷瘤裸鼠模型的瘤体上进行对照组、“冷”球组、不同剂量组（９０Ｙ－ＧＴＭＳ剂量分组为９２．５、１８５、３７０ＭＢｑ，３２Ｐ－ＧＴＭＳ剂量分组为３７、９２．５、１８５ＭＢｑ）的治疗，治疗后不同时间观察疗效，获得核素在单位体积中有效剂量后应用于临床。借助Ｂ超对肿瘤定位后直接穿刺注入９０Ｙ－ＧＴＭＳ，或在手术中直接将３２Ｐ－ＧＴＭＳ植入肿瘤内，并随访肿瘤大小变化。动物实验证实，瘤体为（０．２６２±０．０５０）ｃｍ３时，需９０Ｙ－ＧＴＭＳ用量＞１８５ＭＢｑ或３２Ｐ－ＧＴＭＳ用量＞９２．５ＭＢｑ作为有效剂量；核素在肿瘤中随植入时间延长，疗效更明显。临床应用中，１６例肝癌患者行Ｂ超引导下穿刺介入９０Ｙ－ＧＴＭＳ治疗和６例术中部分肿瘤介入３２Ｐ－ＧＴＭＳ治疗者，Ｂ超与ＣＴ显像见９７％癌性肿块缩小或不增大，病理示癌细胞坏死。此结果表明：９０Ｙ、３２Ｐ－ＧＴＭＳ介入治疗对失去手术治疗机会的肿瘤患者提供了有效的姑息治疗手段。

オ┆?0YGTMS and 32PGTMS is injected directly into the carcinoma mass to kill the cancerous cells, prevent the tumour from growing and prolong the life of the malignant tumour patients. In the tumour body of the Dutch rat model, the contrast group,the cryogen group and the differential dose group (90YGTMS divided into 92.5,185,370 MBq,32PGTMS divided into 37,92.5,185 MBq) are observed the curative effect at the different time.The effective dose of the nuclide per unit voume is gotten to be used in clinical practice. With the help of Bultrasonography, the tumour is located and then directly injected 90YGRMS with puncture.32PGTMS is embedded directly into the tumour during the operation and then the change of the tumour size is observed. With the proof of animal experiment, when the volume of the tumour is (0.262±0.050)cm3,the amount of 90YGRMS>185 MBq or 32PGTMS>92.5 MBq is used as effective dose. The longer time the nuclide is embedded in the tumour, the more obvious the curative effect is. In the clinical practice, leading by the Bultrasonography, 16 liver cancer patients receive the 90YGRMS with punctura and 6 patients received the 32PGTMS treatment in some part of the tumour during the operation. Their Bulatrasonography and CT development shows that 97% of the mass has becomes smaller or doesn′t become larger any more, and the pathology displays that the cell has narcotized. 90YGTMS,32PGTMS intervening treatment can provide an effective palliative treatment to those tumour patients, who have lost the chance of surgical operation.