摘要
目的 探讨125I粒子植入联合高强度聚焦超声（HIFU）治疗肝癌门静脉癌栓（PVTT）的临床应用价值.方法 回顾性分析2011年3月至2013年10月19例125I粒子植入联合HIFU治疗的肝癌PVTF患者（男17例,女2例,平均年龄50岁;Ⅰ～Ⅲ级分别为8、7和4例）的临床特征及生存资料,125I剂量为90～ 120 Gy,单个粒子活度为18.5 MBq;HIFU参数：频率0.85 mHz,总治疗时间33～70 min,平均辐照功率300～ 400 W.随访评估疗效及不良反应（3～ 24个月）,观察治疗前后癌栓大小的变化、术后并发症及患者生存率等;采用Kaplan-Meier生存曲线分析患者生存率.结果 19例患者均顺利完成治疗,未发生严重并发症.术后1个月复查,癌栓均有不同程度缩小.术后1个月随访,19例中PR 9例,SD 4例,PD 6例.随访3～24个月,平均生存期为（11.6±3.0）个月,Ⅰ、Ⅱ、Ⅲ级中位生存期分别为13.5、7.0和4.0个月;1年和2年生存率分别为47.4％与7.9％.结论 125I粒子植入联合HIFU治疗肝癌PVTT,局部疗效肯定,创伤小且并发症发生率低.
Objective To investigate the clinical efficacy and feasibility of 125I seeds implantation combined with high intensity focused ultrasound （HIFU） for portal vein tumor thrombus （PVTF） from HCC.Methods Nineteen cases of PVTT from HCC （17 males,2 females;average age：50 years,stage：Ⅰ-Ⅲ）undergoing 125I seeds implantation combined with HIFU from March 2011 to October 2013 were retrospectively studied.The radioactivity of each 125I seed was 18.5 MBq and the matched peripheral dose was 90-120 Gy.HIFU parameters were set as follows：ultrasound wave frequency,0.85 mHz;output power,300-400 W;total treatment duration,33-70 min.During the follow-up of 3-24 months,the change of PVTT size,postoperative complications and survival rate were recorded.Kaplan-Meier method was used to analyze the survival rate.Results The treatment was successfully completed in all patients and no serious complications were observed.After 1 month of follow-up,the tumor thrombi shrank in all patients.Among 19 patients,9 achieved PR,4 SD,6 PD.The one-year and two-year survival rates were 47.4% and 7.9%,respectively.The mean survival was 11.6±3.0 months （range：3-24 months）.The median postoperative survival for stages Ⅰ,Ⅱ,Ⅲ was 13.5,7.0,4.0 months,respectively.Conclusion 125I seeds implantation combined with HIFU could be a safe and effective therapy for PVTT from HCC.
出处
《中华核医学与分子影像杂志》
北大核心
2015年第3期182-185,共4页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
国家卫生和计划生育委员会2013年国家临床重点专科建设项目
