Jiang Yong, Huang Zi-Lin, Wu Pei-Hong, Zhang Fu-Jun, Zhao Ming, Huang Jin-Hua, Fan Wei-Jun, Li Chuan-Xing, Gu Yang-Kui, Zhang Liang, Gao Fei, Li Wang
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 5l0060, P. R. China.
Ai Zheng. 2008 Oct;27(10):1082-7.
BACKGROUND & OBJECTIVE: Lymph node metastasis is an important factor affecting tumor staging, treatment and prognosis. Residual or newly developed metastatic lymph nodes after combined therapy will bring difficulty in further treatment for cancer patients. This study was to investigate the clinical value of CT-guided radioactive seed 125I implantation in treating metastatic lymph nodes.
From Nov. 2003 to Apr. 2007, 47 patients with pathologically confirmed malignant tumors received CT-guided radioactive seed 125I implantation to treat a total of 57 metastatic lymph nodes. The diameter of these metastatic lymph nodes ranged from 1.0 to 5.5 cm: 20 (35.1%) of them with diameter of < 2.0 cm, 21 (36.8%) with diameter of 2.0-2.9 cm, 10 (17.5%) with diameter of 3.0-3.9 cm, 6 (10.5%) with diameter of > or = 4.0 cm. Treatment planning system was used to design the distribution of seed 125I. Under CT guidance, 125I seeds of (2.2-3.3) x 10(7) Mq were implanted into the metastatic lymph nodes at a distance of 1.0-1.5 cm. CT or PET-CT re-examination was performed at 1-3 months after seed 125I implantation.
Seventeen patients had pain caused by metastatic lymph nodes and 13 of them had the pain relieved at 5-14 days after 125I implantation, with a response rate of 76.5%. Of the 47 patients, 38 (80.9%) achieved complete remission (CR), 4 (6.4%) achieved partial remission (PR), 3 (4.3%) had no change (NC), 2 (4.3%) had progressive disease (PD); the overall response rate was 89.4%. The major complication was slight hemorrhage developed in 7 patients (14.9%).
CT-guided radioactive seed 125I implantation is effective and safety in treating metastatic lymph nodes, with minimal damage and few complications.
淋巴结转移是影响肿瘤分期、治疗及预后的重要因素。综合治疗后残留或新出现的转移性淋巴结会给癌症患者的进一步治疗带来困难。本研究旨在探讨CT引导下放射性粒子125I植入治疗转移性淋巴结的临床价值。
2003年11月至2007年4月，47例经病理确诊的恶性肿瘤患者接受CT引导下放射性粒子125I植入治疗57个转移性淋巴结。这些转移性淋巴结直径为1.0至5.5 cm：其中直径<2.0 cm的有20个（35.1%），直径2.0 - 2.9 cm的有21个（36.8%），直径3.0 - 3.9 cm的有10个（17.5%），直径≥4.0 cm的有6个（10.5%）。采用治疗计划系统设计粒子125I的分布。在CT引导下，将活度为(2.2 - 3.3)×10(7) Mq的125I粒子植入转移性淋巴结，间距为1.0 - 1.5 cm。125I粒子植入后1 - 3个月进行CT或PET - CT复查。
17例患者有转移性淋巴结引起的疼痛，其中13例在125I植入后5 - 14天疼痛缓解，缓解率为76.5%。47例患者中，38例（80.9%）达到完全缓解（CR），4例（6.4%）达到部分缓解（PR），3例（4.3%）无变化（NC），2例（4.3%）病情进展（PD）；总有效率为89.4%。主要并发症为7例患者（14.9%）出现轻微出血。
CT引导下放射性粒子125I植入治疗转移性淋巴结有效且安全，损伤小，并发症少。
