CT引导^(125)I近距离挽救治疗胃肠胰神经内分泌瘤的临床应用分析

CT guidesalvage therapy of gastrointestinal pancreatic neuroendocrine tumor's recurrence and metastasis

目的探讨CT引导胃肠胰神经内分泌瘤(GEP-NET)复发和转移的^(125)I近距离挽救治疗。方法 12例胃肠胰神经内分泌瘤复发和转移患者,采用^(125)I放射性粒子进行挽救治疗。所有患者经病理确诊并经过通过系统的手术治疗或者化疗,4例经过生物治疗后复发。其中男4例,女8例,年龄42~79岁,中位年龄56岁。处方剂量(PD)范围为90~140Gy,计划靶体积(PTV)为肿瘤靶体积(GTV)外各个方向上均匀外扩1cm。结果 12例患者均完成2~4次不等的放射性粒子治疗,3、6、9、12、18月局部控制率分别为100%、100%、84.62%、61.54%、38.46.5%,放射性粒子治疗并发症:少量出血3例,皮肤色素沉着1例。结论 CT引导^(125)I近距离治疗作为GEP-NET复发或者转移性的挽救性治疗安全有效。

Objective To discuss how to use CT to guide treatment of iodine-125 for the recurrence and metastatic of the gas-trointestinal pancreatic neuroendocrine tumor （ gep-net ） . Methods 12 patients with gastrointestinal pancreatic neuroendocrine tumor recurrence and metastasis are treated with the iodine-125 radioactive particles. All patients are pathologicaldiagnosed and treated by surgery or chemotherapy systematically, in which 4 cases reoccur after biological treatment, including 4 males and 8 fe-males;aged from 42 to 79 years, median age 56 years old. Prescribed dose （ PD） range is 90~140 Gy, planning target volume （ PTV） is the tumor target volume （ GTV） uniformly enlarged 1 cmin in all directions. Results 12 cases all finished 2~ 4 time-streatment of radioactive particles, the local control rates of 3, 6, 9, 12 and 18 months were 100%, 100%, 84. 62%, 61. 54%, 38. 46. 5%. The complications of the radioactive particles treatment include a small amount of bleeding in 3 cases, skin pigmenta-tion in 1 case. Conclusion CT guide iodine-125particles to closely treat the recurrence and metastatic of GEP-NET is safe and effective.