^(125)碘放射粒子植入术在老年晚期直肠癌的临床应用

CLINICAL EFFICACY OF RADIOTHERAPY WITH IODINE-125 SEED BRACHYTHERAPY IN OLD AGES ADVANCED RECTAL CANCER

目的探讨125碘放射粒子植入术治疗老年晚期直肠癌的临床疗效及其相关因素。方法对已经不能手术切除老年晚期直肠癌20例实施125碘放射粒子植入手术,比较分析了术后肿瘤局部控制率、生存率、并发症及其相关影响因素。结果本组病例中,CR2例(10%);PR12例(60%):AC5例(25%);PD1例(5%);有效率70%。平均缓解期4个月(相当于125碘粒子2个半衰期),肿瘤局部中位控制率为12个月。术后1、2、3年实际局部控制率为39%、15%和10%,术后1、2、3年生存率分别为60%、32%和16%。肿瘤体积大、植入粒子总活度高、未能实施减瘤切除手术、年龄偏大及体质虚弱等导致术后生存率降低。结论125碘放射粒子植入术可以作为老年直肠癌有效、安全、并发症较少的姑息治疗方法。

Objective To evaluate the clinical efficacy and related iactors of advanced rectal cancer in old a- ges treated by radiotherapy with iodine- 125 seed brachytherapy. Methods Twenty old patients who suf- fered from advanced rectal cancer underwent radiotherapy with iodine- 125 seed brachytherapy were select- ed, then the survival rate, complications and other related factors were compared and analyzed. Results In all 20 cases, completed response（ CR） was 2 cases { 10 % ）, partial response was 12 cases （ 60 %）, stable dis- ease was 5 cases（25% ）, progressive disease was 1 case （5%） , effective rate was 70 %. The average CR time was four months, which was two times the half- life of iodine- 125, while the mean local control rate was 12 months. Postoperative local control rate and postoperative survival rate after 1, 2, 3 years were 39%, 15%, 10% and 60%, 32%, 16%, respectively. The large tumor volume, high levels activity of to- tal amount, failure to implement surgery, advanced age and feebleness leaded to a relatively low postopera- tive survival rate. Conelusion Radiotherapy with iodine- 125 seed brachytherapy is an effective, safe, less - complications palliative treatment for advanced rectal cancer in the older.