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CT引导下¹²⁵I放射性粒子植入治疗复发性/转移性盆腔恶性肿瘤的短期和中期临床疗效

[Short- and medium-term clinical effects of CT guided (125)I radioactive seeds implantation in treatment of recurrent/metastatic malignant pelvic tumors].

作者信息

Zhang Fu-Jun, Jiao De-Chao, Li Chuan-Xing

机构信息

Department of Imaging and Interventional Radiology, State Key Laboratory of Oncology in Southern China, Guangzhou 510060, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Nov 25;88(43):3063-7.

Abstract

OBJECTIVE

To investigate the Short- and medium-term clinical effects of clinical value of CT guided radioactive seed (125)I implantation in treating recurrent/metastatic malignant pelvic tumors.

METHODS

30 patients (10 males and 20 females, the age ranges from 31 to 85, median 55 years) with recurrent/metastatic malignant pelvic tumors after combined therapy such as surgery, chemotherapy and radiotherapy et al, were enrolled in this study. The total lesions were 32 and the max diameter of each lesion ranges from 3.0 cm to 12.2 cm, median 4.8 cm. Under CT guidance, the operations were performed under local anesthesia and (125)I seeds of 2.96 x 10(7) Bq were implanted into tumors at a distance of 0.5 cm according to TPS (Treatment Plan System), and the MPG (matched peripheral doses) was 100 - 160 Gy Observed the the local control rate, overall survival rate, pain reliefs and clinical complications after 2 - 40 months follow-up (median 28 months).

RESULTS

After 2 - 40 months follow-up (median 28 months), 10/32 obtained CR, 13/32 obtained PR, 5/32 NC and 4/32 PD. The clinical effective rate was 87.5% (CR + PR + SD > 2 months). 1- and 2-year Local control rate were 83.3% and 62.5%, and overall 1- and 2- and 3- year survival rate were 87.7%, 73.1% and 45.7%, respectively, the median survival time was 28 months. The rate of pain relief was 21/23 (91.3%). Complications in the long term were Grade I - II radioactive rectum proctitis observed in 3 cases, Grade I radioactive cystitis observed in 1 case, insensible feeling in lower limb observed in 1 case for a long time. No other severe complications such as menorrhoea, acute pulmonary embolism, abscess, intestinal fistula, intestinal perforation, sinus tract were encountered in all patients.

CONCLUSION

CT guided radioactive seed (125)I implantation procedure can be a simple, safe and effective method in treating recurrent/metastatic malignant pelvic tumors, which can ease the pain of patients and improve the qualities of patients' lives and obtain good clinical effects with minimal damage and few complications.

摘要

目的

探讨CT引导下放射性粒子(125)I植入治疗复发性/转移性盆腔恶性肿瘤的临床价值及中短期临床疗效。

方法

选取30例经手术、化疗、放疗等综合治疗后复发/转移的盆腔恶性肿瘤患者(男10例,女20例,年龄31~85岁,中位年龄55岁)。共32个病灶,每个病灶最大直径3.0~12.2 cm,中位直径4.8 cm。在CT引导下,于局部麻醉下行手术,根据治疗计划系统(TPS)将2.96×10(7)Bq的(125)I粒子以0.5 cm的间距植入肿瘤内,匹配周边剂量(MPG)为100~160 Gy。随访2~40个月(中位28个月),观察局部控制率、总生存率、疼痛缓解情况及临床并发症。

结果

随访2~40个月(中位28个月),32个病灶中完全缓解(CR)10个,部分缓解(PR)13个,疾病稳定(NC)5个,疾病进展(PD)4个。临床有效率为87.5%(CR+PR+疾病稳定>2个月)。1年和2年局部控制率分别为83.3%和62.5%,1年、2年和3年总生存率分别为87.7%、73.1%和45.7%,中位生存时间为28个月。疼痛缓解率为21/23(91.3%)。长期并发症:3例出现Ⅰ~Ⅱ级放射性直肠炎,1例出现Ⅰ级放射性膀胱炎,1例长期出现下肢感觉减退。所有患者均未出现月经异常、急性肺栓塞、脓肿、肠瘘、肠穿孔、窦道等其他严重并发症。

结论

CT引导下放射性粒子(125)I植入术是治疗复发性/转移性盆腔恶性肿瘤的一种简便、安全、有效的方法,能缓解患者疼痛,提高患者生活质量,损伤小、并发症少,临床效果良好。

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