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放射性粒子¹²⁵I植入治疗肝癌肝移植术后复发转移

[Radioactive seed 125I implantation in treating recurrence and metastasis after liver transplantation in hepatoma].

作者信息

Zhang Fu-jun, Li Chuan-xing, Wu Pei-hong, Li Kui, Huang Jin-hua, Fan Wei-jun, Zhang Liang, Gu Yang-kui, Lu Ming-jian, Wu Yue-xia, Wang Jun-jie

机构信息

Department of Imaging and Interventional Radiology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2007 Apr 10;87(14):956-9.

Abstract

OBJECTIVE

To investigate the clinical value of CT-guided radioactive seed (125)I implantation in treating recurrence and metastasis after liver transplantation in hepatoma.

METHODS

Eleven patients with recurrence and metastasis after liver transplantation for hepatoma, with 45 metastatic lesions, 2.5 cm in diameter on average totally 9 males and 2 females, aged 56 (35 approximately 68), underwent CT-guided radioactive seed 125I implantation for 33 man-times. 125I seeds of the radioactivity of 30 MBq at a distance of 0.5 approximately 1.0 cm were implanted into the recurrence and metastasis lesions according to TPS system before the operation. The matched peripheral dosage (MPD) was 100 approximately 150 Gy, and the number of radioactive seeds for one patient ranged 10 approximately 100.

RESULTS

Among the 45 lesions, 17 obtained CR, 20 PR, 7 NC, and 1 PD. The response rate was 82.2%. Side effects occurred during the procedure including pneumothorax in 1 cases with the lung compressed less than 30 percent, bleeding in 3 cases, and blood in sputum and defervescence in 5 cases. Seeds migration 2 months after the operation occurred in 2 cases. WBC decreased slightly in 2 cases 2 weeks after the operation, with the WBC count >or= 3 x 10(9)/L. No other severe complications, such as massive hemorrhage, bile fistulae, and pancreatic fistula were seen.

CONCLUSION

CT guided radioactive seed 125I implantation procedure has good clinical effects with minimal damage and few complications in treating recurrence and metastasis after liver transplantation in hepatoma.

摘要

目的

探讨CT引导下放射性粒子(125)I植入治疗肝癌肝移植术后复发转移的临床价值。

方法

11例肝癌肝移植术后复发转移患者,共45个转移病灶,平均直径2.5 cm,男9例,女2例,年龄56岁(35~68岁),行CT引导下放射性粒子125I植入33人次。术前根据TPS系统将放射性活度为30 MBq的125I粒子在距离0.5~1.0 cm处植入复发转移病灶内。匹配周边剂量(MPD)为100~150 Gy,1例患者植入的放射性粒子数为10~100粒。

结果

45个病灶中,17个达完全缓解(CR),20个部分缓解(PR),7个疾病稳定(NC),1个疾病进展(PD)。有效率为82.2%。术中出现的不良反应包括1例气胸,肺压缩小于30%;3例出血;5例痰中带血及发热。术后2个月发生粒子迁移2例。术后2周2例白细胞轻度下降,白细胞计数≥3×10⁹/L。未见其他严重并发症,如大出血、胆瘘、胰瘘等。

结论

CT引导下放射性粒子125I植入治疗肝癌肝移植术后复发转移临床效果良好,损伤小,并发症少。

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