^(125)I粒子植入联合TACE治疗原发性肝癌合并门静脉癌栓

^(125)I Seeds Inplantation Combined with TACE in the Treatment of Portal Vein Tumor Thrombus(PTT) in Primary Hepatocellular Carcinoma

目的本文旨在探讨125I粒子门脉癌栓植入联合TACE治疗原发性肝癌合并门脉癌栓的有效性及安全性。方法选取2007年8月～2010年8月收治的原发性肝癌合并门脉癌栓患者12例,行TACE治疗后1周,在CT或彩超影像引导下对门脉癌栓行125I放射粒子植入术。根据计算机三维治疗计划系统(TPS)进行布源,粒子活度为29.6MBq,粒子间距5～10mm,肿瘤周边匹配剂量为(matched peripheral dose,MPD)90～120Gy,随访观察局部控制率,总体生存率。结果随访6～24个月,6个月后局部病灶评价CR2/12,PR7/12,NC3/12,临床有效率75%(CR+PR);总生存率6个月、12个月、24个月生存率分别为91.6%(11/12)、75%(9/12)33.3%(4/12)。结论 CT导向下125I粒子植入联合TACE治疗肝癌合并门脉癌栓,临床疗效确切,并发症发生率低,是一种简单、安全、有效的方法。

Objective To explore the clinical efficacy and safety of 125I seeds implantation combined with TACE in treatment of portal vein tumor thrombus（PTT） in primary hepatocellular carcinoma. Methods After TACE treating for 1 week, 12 PTT patients from august 2007 to august 2010 were implanted by guide of CT or color doppler ultrasonography. The computer three-dimensional treatment planning system（3D-TPS） was used in treatment （ particle radioactivity 29.6MBq; interparticle distance 5 - 10mm; tumor matched peripheral dose, MPD 90-120Gy ）. Local control rate and overall survival rate were followed up. Results Local disease effect was tested by following up for 6 months （CR2/12 PR7/12 NC3/12）. Clinical effective rate was 75% （CR＋PR）. Meanwhile overall survival rate of 6 months, 12 months, 24 months were 91.6% （11/12）, 75% （9/12）, 33.3% （4/12） respectively by following up for 24 months. Conclusion It is single safety and effective way for 1-125 seeds inplantation combined with TACE to treat portal vein tumor thrombus（PTT） by guide of CT with good clinical effect and lower complications.