^(125)碘粒子组织内放疗在肿瘤外科中的应用

The use of intraoperative implantation of radioactive^(125)I seeds in tumor surgery.

目的 研究术中植入1 2 5碘粒子的方法和疗效。方法 ①临床观察 43例术中见肿瘤外侵 ,残留或 和局部淋巴结转移 ,在靶区植入1 2 5碘 (组织总剂量 110～ 160Gy)。②实验研究 :动物肠吻合口总剂量 113Gy对吻合口愈合的影响。③测定术前、术中、术后辐射对周围人群的影响。结果 1.随访 10～ 2 3月 (平均12 6月 ) ,局部复发 5 % (2 43 ) ,术后无不良反应。 2 .所有实验动物 7天吻合口均愈合良好 ,吻合口羟脯氨酸量组织学检查与对照组差异不明显。结论 术中植入1 2 5碘粒子对局部肿瘤疗效好 ,全身反应小 ,不影响附近外科吻合口愈合 ,易防护。是中晚期肿瘤外科手术的一种理想的综合治疗方法。

Objective To investigate the effect and methods of intraoperative implantation of radioactive 125 I seeds. Methods ① Forty three cases with neoplasms invading outside, remained or metastasizing to local lymph nodes were provided intraoperative implantation of 125 I seeds(total doses 113Gy)② Healing of surgical anastomosis was studied in animal experiments.③The effect of 125 I seeds to the people around patients was assessed. Results ① The 43 cases were followed up 10～23 months (average 12.6), the rate of local recurrence was 5%(2/43). The leukocyte, platelet and functions of liver and kidney haven't been affected in the cases. ② Gross observation, hydroxyproline content and histopathologic change of anastomosis of all experimental animals didn't show remarkable difference compared with control group. Conclusion Intraoperative implantation of 125 I seeds has very high local tumor control rates, hasn't adverse effect on healing of surgical anastomosis. The radioactive protection is easy. It is safe and feasible in clinical practice.