CT引导下^125I近距离治疗肝癌腹膜后转移性淋巴结的临床价值

Clinical value of CT-guided 125I brachytherapy for retroperitoneal metastatic lymph node from

目的探讨CT引导下原发性肝癌腹膜后转移性淋巴结^125I近距离治疗的临床价值。方法对2004年3月至2012年6月中山大学肿瘤医院介入病区20例肝癌腹膜后淋巴结转移的患者行^125I近距离治疗。采用电脑治疗计划系统（TPS）确定植人粒子的数目、剂量、放置部位及穿刺路径；在CT引导下穿刺腹膜后转移性淋巴结，CT扫描确定粒子植入针位置合适后开始排布粒子；治疗后行CT扫描进行术后验证、放疗质量评估。采用增强CT对患者进行随访，评价疗效及安全性。结果^125I近距离治疗后第3、6、10、15个月的局部控制率分别为70．0％、56．3％、44．4％、25．O％：所有患者未发生大量出血及周围正常组织放射性损伤等并发症。结论^125I近距离治疗是肝癌腹膜后转移性淋巴结安全、有效的微创手段。

Objective To discuss the clinical value of CT-guided 125I brachytherapy with retroperitoneal metastatic lymph nodes from primary hepatic carcinoma（PHC）. Methods Twenty patients with retroperitoneal metastatic lymph node recurrence from PHC were percutaneously treated by 125I brachytherapy with computed tomographic （CT） guidance. The number, radioactive dose, placed position of radioactive seeds and puncture path were determined by computerized treatment planning system（TPS）. The radioactive seeds were implanted when the needles were in right position by CT scan. Radiotherapy verification and quality assessment were performed after treatment by CT scan. Follow-up contrast material- enhanced CT were reviewed. Results The local control rate of 3, 6, 10,15 months was 70. 0% , 56. 3% , 44. 4% ,25. 0% respectively. There were no severe complications such as massive bleeding and radiation injury of normal tissues. Conclusion CT-guided 125I braehytherapy are effective and may be safely applied to retropefitoneal metastatic lymph nodes from PHC.