^(125)I粒子植入治疗胶质瘤32例近期疗效观察

The short-term observation of clinical efficacy of ^(125)I seeds implantation in patients with glioma

目的探讨125I粒子植入术治疗脑胶质瘤的近期疗效与安全性。方法回顾性分析青岛大学附属医院2013年6月~2014年6月收治的32例脑胶质瘤患者,其中术后复发患者13例,已行外放疗后复发7例,初始治疗12例。采用CT引导下125I放射性粒子植入术治疗,术后随访6月(3个半衰期),观察分析术后并发症和疗效。结果 32例患者治疗后复查均无颅内出血病例。6例(18.8%)术后出现恶心、呕吐,给予止吐、降低颅内压处理后缓解。4例(12.5%)患者出现外周血白细胞轻度下降(不低于3×109/L),给予升白药物治疗后恢复正常。监测肝肾功能治疗前后无明显变化。125I粒子植入术后2个月、6个月(3个半衰期)随访,术后2月32例患者中CR25.0%(8/32)、PR34.4%(11/32)、NC28.1%(9/32)、PD12.5%(4/32),有效率(CR+PR)59.4%。术后6月C R 34.4%(11/32)、PR37.5%(12/32)、NC21.9%(7/32),PD6.3%(2/32),有效率(CR+PR)71.9%。32例中无死亡及病变进展病例。结论 125I放射性粒子植入治疗脑胶质瘤是微创的、安全的,具有显著的近期疗效。

Objective To investigate the short-term efficacy and safety of to investigate the 125I seed implantation treat- ment of glioma. Methods A retrospective analysis was perfomed in 32 patients with glioma, who received CT-guided 125I radioactive seeds implantation therapy in the Affiliated Hospital of Qingdao University from Apr. 2013 to Jun. 2014. The postoperative follow-up was six months and the postoperative complications and efficacy were analyzed. Results None of 32 patients had no intracranial hemorrhage post treatment. 6 cases （18.8%） appeared postoperative nausea and vomi- ting, which were relieved after treatment with antiemetic and reducing the intracranial pressure. 4 cases （12.5%） had slightly decreased peripheral blood leukocytes （not less than 3 × 10^9/L）, which returned to normal after drug treatment. No significant changes in liver and kidney function were monitored before and after treatment. Follow-- up of 125I implanta- tion was conducted for 2 months and 6 months （three half-life）. The results among 32 patients after two--month were as follows： CR25.0% （8/32）, PR34.4% （11/32）, NC28 . 1% （9/32）, PD12.5% （4/32）, and efficiency （CR ＋ PR） 59.4%. Those at 6 months were CR 34.4% （11/32）, PR37.5M （12/32）, NC21.9% （7/32）, PD6.3%（2/32）, and ef- ficiency （CR ＋ PR） up to 71.9%. There were no deaths and cases of disease progression in 32 cases. Conclusion 125I seeds implantation is a minimally invasive treatment for glioma, which has a significant short-term effect.