^(125)I粒子植入治疗结肠癌肝转移患者的临床研究

Clinical study on ^(125)I seeds implantation for colon cancer patients with liver metastasis

目的研究^(125)I粒子植入治疗结肠癌肝转移患者的疗效。方法选取接受结肠癌根治术治疗的80例结肠癌肝转移患者,按照随机数字表法分为植入组和对照组,每组40例。对照组患者采用单纯化疗,植入组患者采用^(125)I粒子植入治疗+化疗。比较治疗前后两组患者的血清基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶-9(MMP-9)、癌胚抗原(CEA)、甲胎蛋白(AFP)水平,免疫指标CD4^+、CD8^+、CD4^+/CD8^+、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)水平及不良反应的发生情况。结果植入组患者的血清MMP-2、MMP-9、CEA、AFP、CD8^+、CD4^+、CD4^+/CD8^+、IL-6、IL-17治疗前后的差值均明显大于对照组,差异均有统计学意义(P﹤0.01)。植入组患者的ORR为70.00%,高于对照组的42.50%,差异有统计学意义(P﹤0.05)。两组患者的恶心呕吐、中性粒细胞减少、迟发性腹泻、肝功能不全的发生率比较,差异均无统计学意义(P﹥0.05);植入组患者肝区中度疼痛的发生率为85.00%,明显高于对照组的20.00%,差异有统计学意义(P﹤0.01)。结论^(125)I粒子植入治疗结肠癌肝转移可有效地杀灭肿瘤细胞,抑制肿瘤转移,疗效明显,不良反应少,且具有微创特点,值得临床推广应用。

objective To study the clinical efficacy of-（125）I seeds implantation for colon cancer patients with liver metastasis. Method Eighty patients with liver metastasis after radical operation for colon cancer were enrolled and divided into implantation group（n=40） and control group（n=40） in accordance with the random number table. Patients in the control group received chemotherapy only, while patients in the implantation group treated by-（125）I seeds implant ＋ chemotherapy. Before and after treatments, the levels of serum matrix metalloproteinase-2（MMP-2）, and-9（MMP-9）, carcinoembryonic antigen（CEA）, alpha-fetoprotein（AFP）, CD4^＋, CD8^＋, CD4^＋/CD8^＋, interleukin-6（IL-6）, and-17（IL-17）,and indicators of adverse reactions of patients from two groups were detected and compared. Result The difference values before and after treatments of serum MMP-2, MMP-9, CEA, AFP, CD8^＋, CD4^＋, CD4^＋/CD8^＋, IL-6 and IL-17 in implantation group were significantly bigger than those in control group, the differences were statistically significant（P〈0.01）. ORR of implantation group（70.00%） was higher than that of control group（42.50%）（P〈0.05）. During the treatment, there was no significant difference in the incidence of adverse reactions, such as nausea, vomiting, neutropenia, delayed-onset diarrhea and hepatic insufficiency between two groups（P〈0.05）. Incidence of implanted liver pain（85.00%）of implantation group was significantly higher than that of control group（20.00%）（P〈0.01）. Conclusion The-（125）I seeds implantation for patients with liver metastasis after radical operation for colon cancer can kill cancer cells and inhibit tumor metastasis with certain efficacy. And it＇s minimally invasive and with no difference in adverse reactions compared to conventional chemotherapy, indicating the worthy of clinical applications.