缓释化疗粒子和^(125)I粒子联合间质插置治疗实体肿瘤

Treatment of solid tumors by interstitial implantation of slow-released chemotherapeutic granule combined with ^(125)I-seed

目的探讨缓释化疗粒子和125I粒子联合间质插置治疗实体肿瘤的疗效和优势。方法纳入16例因各种原因不能或不愿手术的肺癌、肝癌和直肠癌复发病人,利用TPS将病人CT或MRI影像进行三维立体数字化影像重建,根据肿瘤部位、大小以及周围组织情况,精确制定等剂量曲线和放射粒子、化疗粒子治疗计划,在CT或B超引导下根据治疗计划进行肿瘤穿刺,将125I粒子和化疗粒子植入到预定位置。结果所有病人治疗过程顺利,无严重并发症,术后1、3、6个月肿瘤体积较术前均有明显变化(P值分别为0.04、0.02和0.04)。6个月时有效率81.25%,6个月生存率100%,12个月生存率87.5%。结论放疗粒子和化疗粒子相互有增效作用,它们的联合间质治疗具有创伤小,副作用少,安全性高,疗效显著的特点。

Objective To investigate the therapeutic effects and advantages of interstitial implantation of slow - released chemotherapeutic granule combined with 125I - seed on solid tumors. Methods Sixteen patients with tumors who couldnt or were unwilling to be operated were enrolled in this study, including lung cancer,liver cancer and recurring rectal cancer. Three - dimensional digital structure of their CT or MRI images was reconstructed by tumor plan system （TPS）. According to tumor location, size and status of around tissue, radioactive isometric line was designed, and the therapeutic regimen of 125I - seed and slow - released chemotherapeutic granule was set down accurately. Then 125I - seed and chemotherapeutic granule were put into preset position by puncturing under the guidance of B type ultrasound or CT. Results Treatments in all patients were successful without severe complications. Size of all tumor reduced remarkably at 1,3 and 6 months after treatment （P value was 0.04,0.02 and 0.04,respectively）. The effective rate and survival rate at 6 months after treatment was 81.25% and 100% , respectively, and the survival rate at 12 months was 87.5%. Conclusion Radioactive seed and chemotherapeutic granule can enhance mutual curative effects. Combination of them in interstitial therapy has the advantages of little hurt, less side effect, higher security and notable curative effects.