CT引导下^(125)I粒子组织间植入治疗疼痛性淋巴结转移性腺癌

CT-guided interstitial iodine-125 seed implantation for the treatment of painful lymph node metastasis of adenocarcinoma

目的:探讨CT导向下125I粒子组织间植入治疗疼痛性淋巴结转移性腺癌的疗效和安全性。方法:回顾性分析2010年4月～2010年9月在本院接受CT导向下125I粒子组织间植入治疗的12例淋巴结转移性腺癌患者的病例资料。对比术前与术后患者的疼痛情况、肿瘤大小变化,并观察并发症情况,随访期2～6个月。结果:1例疼痛完全缓解,7例疼痛减轻,4例疼痛无明显变化;无1例疼痛加重,止痛有效率66.7%(8/12);其中4例单发淋巴结肿大者经治疗后疼痛均有缓解(4/4),8例多发淋巴结肿大者4例达到止痛效果。12例经治疗后肿瘤完全缓解1例,部分缓解8例,无变化3例,肿瘤缓解率75.0%(9/12)。所有患者无严重并发症发生。结论:对于疼痛性淋巴结转移性腺癌,CT导向下125I粒子组织间植入可减轻疼痛,缩小肿瘤体积,有效控制肿瘤进展,在掌握适应证和选择合适的穿刺路径前提下,此方法是安全的。

Objective：To evaluate the therapeutic effect and safeness of CT-guided interstitial iodine-125 seed implantation for painful lymph node metastasis of adenocarcinoma.Methods：The clinical materials of 12 patients with painful lymph node metastasis of adenocarcinoma underwent CT-guided interstitial iodine-125 seed implantation during April to September 2010 were retrospectively analyzed.The seriousness of cancerous pain and tumor size before and after treatment as well as complication were compared and evaluated.Follow-up period was 2~6 months.Results：The cancerous pain was completely relieved in 1 case,partial yet obviously relieved in 7 cases,remained unchanged in 4 cases,and no aggravation was assessed.The total pain-relieved rate was 66.7%（8/12 cases）,including pain-relieved rate of 100.0%（4/4 cases） in single lymph node metastasis and 50.0%（4/8 cases） in multiple lymph node metastasis respectively.Of those tumor masses,complete regression（CR）,partial regression（PR）,stable（SD） and progression（PD） were seen in 1,8,3 and 0 cases respectively,the effective rate was 75.0%（9/12 cases）,no serious complication was revealed.Conclusion：Pain relieving,reduce of tumor size as well as effective control of tumor progression of painful lymph node metastasis of adenocarcinoma could be achieved with CT-guided interstitial iodine-125 seed implantation,which provides a safe approach as proper indication and puncture pathway were used.