放射性^(125)I粒子植入治疗特殊部位肝肿瘤的安全性及有效性

Safety and efficacy of Iodine-125 radioactive seed implantation in the treatment of liver malignancies in challenging-location

目的:评估放射性^(125)I粒子植入治疗特殊部位肝肿瘤的安全性及有效性。方法:分析2015年12月—2021年12月采用CT引导下放射性^(125)I粒子植入治疗49例60个特殊部位的肝脏肿瘤的临床资料。主要终点是总生存期(OS),次要终点包括无进展生存期(PFS)、疾病控制率(DCR)、客观缓解率(ORR)及肝内复发率(LRR),评估与肝内复发相关的潜在因素。结果:技术成功率为100%,少数患者出现了术后并发症,对症处理后好转。中位OS为12个月(95%CI:11.6612.34),中位PFS为12个月(95%CI:10.8713.13)。1年DCR、ORR和LRR分别为93.48%、60.87%和28.26%。治疗前与治疗后1个月的血液学指标差异无统计学意义(P>0.05)。对肿瘤复发相关因素行Cox单因素分析,结果显示肿瘤来源是影响患者肝内复发时间的因素(P=0.012)。结论:CT引导下放射性^(125)I粒子植入治疗特殊部位肝肿瘤,是一种安全、有效的治疗方法,具有较高的疾病控制率和良好的生存前景,值得临床上进一步推广应用。

Objective:To evaluate the safety and efficacy of Iodine-125(^(125)I)radioactive seed implantation in the treatment of liver malignancies in challenging locations.Methods:From December 2015 to December 2021,the clinical data of 49 patients with 60 challenging-location liver malignant tumors treated by CT-guided ^(125)I radioactive seed implantation were analyzed.The primary endpoint was overall survival(OS)and secondary endpoints included progression-free survival(PFS),disease control rate(DCR),objective response rate(ORR)and liver recurrence rate(LRR).The potential factors associated with liver recurrence were being evaluated.Results:The technical success rate was 100%.A small number of patients developed postoperative complications,which recovered after symptomatic treatment.The median OS was 12 months(95%CI:11.6612.34)and the median PFS was 12 months(95%CI:10.8713.13).The 1-year DCR,ORR and LRR were 93.48%,60.87% and 28.26%,respectively.There was no significant difference between the hematologic indexes before treatment and 1 month after treatment(P>0.05).Cox univariate analysis was performed on the factors related to liver recurrence,and the results showed that tumor source was a factor affecting the time of liver recurrence in patients(P=0.012).Conclusion:CT-guided ^(125)I radioactive seed implantation for the treatment of liver malignancies in challenging-location is a safe and effective treatment method with high local control rate and good survival prospects,which is worthy of further clinical popularization and application.