放射性粒子^(125)I和^(103)Pd植入治疗肝癌的计量学研究进展

Dosimetry of ^(125)I and ^(103)Pd radioactive seeds implantation in therapy of liver cancer

目的:总结国内外关于放射性粒子125I和103Pd植入治疗肝癌的计量学研究。方法:应用Medline及CNKI期刊全文数据库系统,以"肝癌,碘-125,钯-103"为关键词,检索2000-01-2010-06相关文献。纳入标准:1)125I和103Pd的物理学和生物学性质;2)125I和103Pd在治疗肝癌的相关计量学;3)疗效评价及适应证、禁忌证。根据纳入标准分析28篇文献。结果:粒子植入治疗肝癌简单易行,抑瘤效果明显,总体抑瘤有效率(完全缓解+部分缓解)可以达到>70%,并发症很少,止痛效果好,疼痛缓解率>70%,明显改善了患者的生存质量,取得了很好的临床疗效。粒子植入治疗肝癌关键是设置合理的周边匹配剂量,125I的周边匹配剂量(MPD)设置在80~100 Gy,103Pd的MPD为90~130 Gy是合理的。迄今为止,125I和103Pd粒子植入治疗肝癌没有统一的剂量标准,更没有形成系统性规范,需要进一步的研究和探讨。结论:制定出适用于125I和103Pd植入治疗肝癌精确、科学的剂量学标准是非常有必要的。

OBJECTIVE：To sum up domestic and abroad articles related to dosimetry of^ 125I and^103Pd implantation in therapy of liver cancer.METHODS：＂Liver cancer,^125I and ^103Pd ＂were searched as key words by medline and CNKI series fulltext database retrieval system from 2000-01 to 2010-06.Choice criteria：1）the physical and biological characters of ^125I and ^103Pd.2）dosimetry of 125I and 103Pd implantation in therapy of liver cancer.3）Curative Efficacy evaluation,indication,contraindication.By extraction according to choice criteria,28 paper were analyzed.RESULTS：Radioactive seeds implantation are simple and easy to perform with lower postoperative morbidity,high tumor inhibition rate（overall effective rate 70%） and good analgesic effect（the remission rate of the pain 70%）.They improve the quality of life significantly,and achieve good clinical efficacy.It is crucial to set the suitable MPD for radioactive seeds implantation in therapy of liver cancer.The MPD of ^125I seed implantation are 80-100 Gy,and the MPD of 103Pd seed implantation are 90-130 Gy.However,there is no common and standard in 125I and 103Pd dose for treating liver cancer,let alone the treatment guidelines.Further research and exploration are necessary.CONCLUSION：It is necessary to investigate the accurate and scientific metrology standards in the treatment for liver cancer.