超声引导下^(125)I粒子植入治疗老年乳腺癌的疗效观察

Clinical observation on ultrasound-guided ^(125)I seed implantation in the treatment of senile breast cancer

目的探讨超声引导下放射性125I粒子植入治疗老年乳腺癌的临床疗效。方法回顾性分析2011-06~2014-04于我院超声引导下实施125I粒子植入治疗的15例老年乳腺癌患者的临床资料,评价临床疗效及不良反应。结果全组患者手术顺利,粒子植入数目为15-90粒,平均植入粒子47粒,术后随访5-37.5个月,平均20.5个月。至随访结束时,完全缓解(CR)4例,部分缓解(PR)9例,疾病稳定(SD)1例,病情进展(PD)1例,总有效率(RR)达86.7%,1年生存率为91.67%。随访期间,死亡1例,死亡病例的无进展生存期为10.5个月。术后3个月患者KPS评分较术前明显提高,患者血清CEA、CA153、CA125水平较术前明显降低,差异有统计学意义(P<0.05)。所有病例术后无严重并发症及不良反应。结论超声引导下125I粒子植入治疗老年乳腺癌安全有效、不良反应少,为老年乳腺癌的治疗提供了新方法。

Objective To explore the clinical effectiveness of ultrasound-guided radioactive 125I seed implantation in the treatment of se- nile breast cancer. Methods The clinical data of 15 elderly patients with breast cancer treated by ultrasound-guided 125I seed implanta- tion from June 2011 to April 2014 in our hospital were retrospectively analyzed. The clinical effectiveness and adverse reactions were ob- served. Results All patients smoothly completed surgery. The number of implanted seeds was 15 -90. Forty-seven 125I seeds were im- planted on average. The patients were followed-up for 5 -37.5 months（ average 20.5 months）. After fowllow-up ,4 cases were in complete response（CR） ,9 cases were in partial response（PR）, 1 case was in stable disease （SD）and 1 case was in progressive disease. The re- sponse rate（RR） was 86.7%. During the follow-up, 1 case died, and the progression-free survival of dead cases was 10.5 months. One- year survival rate of all cases was 91.67%. Three months after implantation,Karnofsky score was increased significantly, and the concen- trations of serum tumor markers（ CEA, CA153, CA1125 ） were decreased significantly （ P 〈 0.05 ）. No serious postoperative complications and adverse reactions occurred. Conclusion Ultrasound-guided 125I seeds implantation for senile breast cancer is safe and effective with less adverse reaction,which provides a new treatment way for the elderly patients with breast cancer.