TACE联合CT导向下^(125)I放射性粒子植入治疗肝癌

TACE combined with CT-guided ^(125)I radioactive particle implantation for the treatment of hepatic cancer

目的探讨经皮导管动脉化疗栓塞术(TACE)联合CT导向下125I放射性粒子植入治疗肝癌的方法。方法16例接受过碘油栓塞治疗的患者术前均行CT扫描,根据扫描结果制订术前计划,确定放射性粒子植入数量及位置,勾画肿瘤靶区时应超出碘油沉积范围0.5～1.0 cm,125I粒子平均能量27～35 keV。结果27例患者中完全缓解2例,部分缓解16例,无变化6例,进展3例,总有效率66.7%。术后6个月随访,除1例死于远处转移外,其余患者均生存。结论TACE联合CT导向下125碘放射性粒子植入是治疗肝癌的安全有效的方法。

Objective To investigate the technical points and the clinical effectiveness of transcatheter arterial chemoembolization （TACE） combined with CT-guided ^125I radioactive particle implantation for the treatment of liver cancer. Methods Twenty-seven patients with hepatic cancer, proved by color Doppler ultrasonography, CT and AFP, were enrolled in this study. All the patients received embolization therapy with lipiodol not long before. Of the 27 patients, preoperative CT scanning was performed in 16. Based on the CT findings, the therapeutic protocol was formulated to determine the amount and site of ^125I radioactive particle to be implanted. When drawing the outline of target area, the targeted sedimentation extent which was delineated on CT scan should be exceeded the area with deposits of lipiodol by 0.5 - 1.0 cm. The average energy of ^125I radioactive particle was 27 - 35 keV. Results Of 27 patients, complete remission was seen in 2, partial remission in 16, unchanged condition in 6 and exacerbation of the condition in 3, with a total efficiency of 66.7%. The patients were followed up for 6 months. One patient died of distant metastasis and the remaining ones survived so far. Conclusion Transeatheter arterial chemoembolization combined with CT-guided ^125I radioactive particle implantation is a safe and effective treatment for liver cancer.