^(125)I放射性粒子植入治疗腹膜后淋巴结转移的临床研究

The clinical study of radioactive iodine-125 seed implantation for retroperitoneal lymph node metastasis

目的回顾性研究放射性粒子组织间植入治疗腹膜后淋巴结转移的可行性、临床效果及作用机理。方法收集腹膜后淋巴结转移患者42例,均在CT导引下进行125I粒子植入术。术后存活1、6、12、24个月的患者分别进行CT扫描及临床症状缓解情况的随访,以疼痛缓解情况和肿瘤体积大小变化与术前比较为主要判定指标,判定临床是否有效。统计学方法采用SPSS 13.0进行术前、术后体积配对设计t检验进行统计分析,P<0.05判定为差异有统计学意义。结果术后存活1个月患者组42例,临床症状缓解38例,肿瘤体积缩小38例;术后存活6个月患者组32例,临床症状缓解29例,肿瘤体积缩小27例;术后存活12个月患者组28例,临床症状缓解23例,肿瘤体积缩小21例;术后存活24个月患者组为19例,临床症状缓解14例,肿瘤体积缩小14例。治疗后患者存活1、6、12、24个月各患者组随访复查其差异均有显著统计学意义。结论 125I粒子植入术治疗腹膜后淋巴结转移副作用小,并发症少,是安全可行的。在缓解疼痛,控制肿瘤生长及提高生活质量方面取得了满意的近期疗效。

Objective To evaluate the feasibility, clinical value, mechanism of implantation of 125I in threatening tetra peritoneal lymph node metastasis. Methods We retrospectively analysed 42 cases of pretroperitoneal lymph node metasta sis patients. All the patients received interstitial 12aI permanent implantation. In the first month, sixth month, twelfth and 24 th month after operation respectively, follow-up visit was performed CT scan review, in accordance with changes of tumor size, clinical remission to determine the extent of mitigation. Statistic soft SPSS 13.0 was applied to analyze the conditions of tumor＇s size before and after treatment, and carried out matched t-test. P d0.05 had statistical differences. Results 42 cases of pancreatic cancer patients survival one mongth after operation, 38 cases of clinical symptoms were re duce, 38 cases of tumor volume were shrunk; 32 cases of pancreatic cancer patients survived in six months after operation, 29 cases of clinical symptoms were dreduced, 27 cases of tumor volume were shrunk; 28 cases of pancreatic cancer patients survied in 12 months after operation, 23 cases of clinical symptoms were reduced, 21 cases of tumor volume were shrunk; 19 cases of pancreatic cancer patients survived in 24 months after operation, 14 cases of clinical symptoms were reduced, 14 cases of tumor volume were shrunk; After treatment in first, sixth, twelfth, 24 th month, all the survival follow-up re view had significant statistical differences. Conclusion Interstitial implantation of 1251 permanent particle treatment of ret-roperitoneal lymph node metastasis is an effective and safe treat ment. It can reduce the tumor volume and improve the pa tient＇s symptoms and signs significantly, with fewer complications.