经CDFI引导^(125)I粒子植入治疗转移性浅表肿瘤疗效观察

Clinical Significance of CDFI-guided ^(125)I Seed Implantation in The Treatment of Metastatic Superficial Tumor

目的探讨彩色多普勒超声(CDFI)引导下125I粒子组织间植入治疗转移性浅表肿瘤的疗效。方法回顾性分析156例确诊为恶性转移性浅表肿瘤患者进行125I粒子治疗结果,利用薄层CT扫描图像进行计算机三维治疗计划系统(TPS)术前计划、术中调整、术后验证粒子分布及数量。局部浸润麻醉后,CDFI引导下植入125I粒子。结果术后3个月,16.7%(26/156)患者肿瘤完全缓解,51.3%(80/156)患者肿瘤部分缓解,21.1%(33/156)肿瘤稳定,10.9%(17/156)肿瘤进展,总有效率(CR+PR)为68%。术后6个月,18.6%(29/156)患者肿瘤完全缓解,53.2%(83/156)患者肿瘤部分缓解,22.4%(35/156)肿瘤稳定,5.8%(9/156)肿瘤进展,总有效率(CR+PR)为71.8%。无严重皮肤反应、骨髓抑制及其它并发症发生。结论 CDFI引导下125I粒子植入治疗转移性浅表肿瘤具有方法简单、定位准确、疗效确切、无严重并发症等优点,是一种安全的微创治疗手段。

Objective To analyze the clinical effect of CDFI-guided t25I seed implantation in the treatment of metastatic superficial tumor. Methods A retrospective analysis of 156 patients with metastatic superficial tumors treated with CDFI-guided lzsI seed implantation was carried out. Three-dimensional computerized reconstruction and CT scanning with thin slice were used to make preoperative p/an, operative adjustment and to verify the distribution and numbers of seeds after operation, The 125I seed were implanted under CDFI-guided after local infiltration anesthesia. Results Three month after operation, The tumors in 16.7% of patients （26/156） were complete remission （ CR）, 51.3 % patients （ 80/156 ） were partial remission （ PR）, 21.1% patients （ 33/ 156） had no change （NC）, 10.9% patients （17/156） had progress disease （PD）. The total effect rate was 68% （CR ＋ PR）. Six month after operation, The tumors in 18.6% of patients （29/156） were complete remission （ CR）, 53.2 % patients （83/156） were partial remission （ PR）, 22.4% patients （35/156） had no change （NC）, 5.8% patients （9/156） had progress disease （PD）. The total effect rate was 71.8% （CR ＋ PR）. There were no serious skin reactions, bone marrow suppression and other complications in all patients. Conclusion Brachytherapy with 125I seeds implantation guided with CDFI is a safe, minimally invasive and effective treatment method for metastatic sm）erficial tumor.