人体鼻咽癌放疗支架的研制

Development of the Radioactive Stent of Human's Nasopharyngeal Carcinoma

目的:研制一种能够对鼻咽癌实施近距离放射治疗的支架,其既能够在保证肿瘤控制率的基础上,也能够将正常组织并发症发生概率降低至可接受范围。方法:鼻咽部位的放疗支架因要在支架一端覆放射膜,因此宜选用带记忆功能材料制造成网格形状的支架,目前临床使用较多的为NiTi合金材料制造的支架。用该种材料制造的金属支架在人体体温条件下可以自动恢复支架形状并具备一定的支撑力。临床研究表明,从预后结果和并发症来看,对所有类型的患者来说,103Pd和125I近距离治疗的结果并没有什么差别,因此对于应用哪种核素,美国近距离放疗学会(ABS)没有倾向性意见,但是建议对103Pd和125I的疗效做进一步研究。结论:近距离放射治疗管腔肿瘤并不是一个新方法。进行103Pd或125I覆膜的管腔支架植入,对那些经过筛选符合条件的局限性的管腔肿瘤患者来说,不失为一种较理想的选择。与传统和外放疗相比,植入后的近距离治疗可以使局部肿瘤组织获得更高的剂量,而且不需外科手术,更方便患者,对患者具有很大的吸引力,只要掌握好适应症,一般不会出现并发症,对患者生活影响很小。

Purpose：To develope a new brachytherapy nasopharyngeal carcinoma stent,which can both control the rate of tumor and reduce the complications of normal tissue to an acceptable range.Method：The brachytherapy stent must have radiation film coated on one end,so the grid shape stent with memory materials is a better choice.NiTi alloy stent has the most widely use in current clinical application.This type of stent can automatically restore there bracket shape under body temperature and have support force.Clinical studies have shown that the brachytherapy with 103Pd and 125I have no difference for all types of patients,and the prognosis and thecomplications also have no difference.The United States Brachytherapy Society（ABS） have not expressed their preference,but they recommended further study be done to both 103Pd and 125I.Considering the link between the half-life of radioactive isotopes and the production cycle,125I with 60.2-day half-life is more reasonable than 103Pd with 2.7-day half-life.Conclusion：Brachytherapy is not a new method for theraping the luminal tumors.To plant 103Pd or 125I covered stent into those patients＇ body who is eligible for the limitations of luminal cancer is an ideal choice.The partial tumor can get higher dose with brachytherapy stent planted in body compared with traditional external radiation.This treatment do not need surgery and is more convenient.It is very attractive to patients.Complications do not appear under normal circumstances and have little impact to the life of patients.