125I放射性粒子植入治疗乏氧肿瘤近期疗效的临床研究

Short-term efficacy of iodine-125 radioactive seed implantation therapy for hypoxic tumors

目的研究125I放射性粒子在cT引导下植入治疗乏氧性肿瘤的近期疗效。方法通过多普勒彩色超声仪检测实体瘤内血流信号，将2014-2016年于我科行125I放射性粒子植入治疗22例肿瘤患者分为少血供组（乏氧组）12例和多血供组（非乏氧组）10例。经增强CT定位扫描后将影像学数据传输至三维粒子植入TPS上设计术前计划，然后行125I粒子植入治疗。术后剂量学验证靶区剂量D90为106-128eGy：术后1-3个月按照WHO标准评价病灶缓解情况。结果两组术后3个月总有效率为82％：乏氧组和非乏氧组有效率（CR＋PR）相近，术后1个月P=0．840，术后2个月P=0．696，术后3个月P=0．840。结论125I放射性粒子植入治疗实体恶性肿瘤可以克服乏氧性肿瘤体外放疗的抗拒性并获得满意近期疗效。

Objective To study the short-term efficacy of computed tomography （CT）-guided iodine-125 （125I） radioactive seed implantation in the treatment of hypoxic tumors. Methods Twenty-two patients treated with 125I radioactive seed implantation in our department from 2014 to 2016 were divided into hypovascular tumor group （ hypoxic group, n = 12） and hypervascular tumor group （ non-hypoxic group, n = 10） based on the hemodynamics of solid tumor evaluated by color Doppler ultrasound. The enhanced CT images were loaded to the three-dimensional particle implantation planning system for preoperative planning. After 125I radioactive seed implantation, the D90 for target volume was verified to be 106-128 cGy. Treatment outcomes were evaluated according to the World Health Organization criteria at 1-3 months after surgery. Results In all the patients, the overall response rate was 82% at 3 months after surgery. There were no significant differences in response （complete response ＋ partial response） rates at 1, 2, or 3 months after surgery between the hypoxie group and the non-hypoxic group （P = 0. 840, 0. 696, 0. 840）. Conclusions In the treatment of solid malignant tumor, 1251 radioactive seed implantation can overcome the resistance of hvnoxie tumor to radiotheranv in vitro and achieve satisfactory short-term efficacv.