CT引导下^(125)I粒子植入治疗胃肠道恶性肿瘤腹壁切口转移

CT-guided ^(125)I seeds implantation for abdominal wall incision metastasis of gastrointestinal malignancies

目的评估^(125)I粒子植入治疗胃肠道恶性肿瘤腹壁切口转移的有效性和安全性。方法收集2011年1月至2021年12月在苏州大学附属第三医院接受CT引导下^(125)I粒子植入治疗胃肠道恶性肿瘤术后腹壁切口转移患者的临床资料。纳入17例患者,17处病灶接受CT引导下^(125)I粒子植入治疗。治疗计划系统(TPS)进行术前规划,CT引导下^(125)I粒子植入。术后每3个月进行随访,评估病灶局部控制率、治疗相关不良反应及疼痛缓解程度。结果胃肠道恶性肿瘤腹壁切口转移17处病灶均在CT引导下成功植入^(125)I粒子共372粒,平均21.9粒/处,处方剂量100 Gy/处。患者平均生存时间9.8个月。首次治疗后3个月CT扫描结果显示17处病灶中,完全缓解3处,部分缓解6处,病灶稳定7处,进展1处,局部控制率为94.1%。术后第6、12个月局部客观缓解率分别为63.6%、33.3%,疾病控制率分别为100.0%、50.0%。术前8例存在局部疼痛,术后3个月疼痛缓解6例,4例NRS疼痛评分下降≥2分。术后未发生严重并发症。结论CT引导下^(125)I粒子植入治疗胃肠道恶性肿瘤腹壁切口转移安全、有效。

Objective To evaluate the efficacy and safety of CT-guided ^(125)I seeds implantation for the treatment of abdominal wall incision metastasis of gastrointestinal malignancies.Methods The clinical data of 17 patients with abdominal wall incision metastasis of gastrointestinal malignancies(17 lesions in total),who received CT guided ^(125)I seeds implantation at the Third Affiliated Hospital of Soochow University of China between January 2011 and December 2021,were collected.The treatment planning system was used to make preoperative planning for CT-guided ^(125)I seeds implantation.Follow-up visit was performed once every 3 months to assess the local control rate,treatment-related adverse effects,and degree of pain relief.Results Successful CT-guided ^(125)I seeds implantation was accomplished for the 17 lesions of gastrointestinal malignant tumor incision metastasis.A total of 372 ^(125)I seeds were implanted with an average of 21.9 seeds per lesion.The average prescription dose was 100 Gy per lesion.The average survival time was 9.8 months.CT scan performed at3 months after first-time implantation showed that among the 17 lesions complete remission was obtained in 3,partial remission in 6,stable disease in 7 and progression in one,with a local control rate of 94.1%.The postoperative 6-month and 12-month local objective remission rates were 63.6%and 33.3%respectively,disease control rates were 100%and 50%respectively.Before treatment 8 patients had local pain,and 3months after treatment pain relief was observed in 6 patients,and in 2 patients the NRS pain score was decreased by≥2 points.No serious postoperative complications occurred.Conclusion For the treatment of abdominal wall incision metastasis of gastrointestinal metastasis,CT-guided ^(125)I seeds implantation is clinically safe and effective.