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CT引导下经皮穿刺植入¹²⁵I粒子治疗胰腺癌的有效性与安全性

Effectiveness and security of CT-guided percutaneous implantation of (125)I seeds in pancreatic carcinoma.

作者信息

Yu Y-P, Yu Q, Guo J-M, Jiang H-T, Di X-Y, Zhu Y

机构信息

1 Department of Radiology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China.

出版信息

Br J Radiol. 2014 Jul;87(1039):20130642. doi: 10.1259/bjr.20130642. Epub 2014 Apr 15.

Abstract

OBJECTIVE

To assess the effectiveness and security of CT-guided percutaneous implantation of iodine-125 ((125)I)-labelled seeds in pancreatic carcinoma.

METHODS

A total of 36 patients (25 males and 11 females) with an average age of 57 years (range, 39-84 years) were enrolled and categorized into Stage III (27 cases) and Stage IV (9 cases) of pancreatic cancer. There were 3 tumours in the pancreatic head and 33 tumours in the pancreatic body or tail. The average diameter of the tumours was 37.1 mm (range, 15-65 mm). The implantation of (125)I seeds was performed by using 18-G needles (length, 150-200 mm) through the anterior, lateral and posterior approaches. Then, (125)I seeds were loaded and released into the lesions.

RESULTS

Implantations were performed via the anterior (23 patients), lateral (9 patients) and posterior (4 patients) approaches. During implantation, 3-14 punctures were performed for each patient, and a total of 164 punctures were recorded. Meanwhile, a total of 657 seeds were implanted with an average of 25.27 (range, 12-50) seeds per patient, and the success rate was 100%. The activity of each seed ranged from 0.55 to 0.65 mCi. A main adverse event occurred in one puncture and minor events in seven punctures. No significant relationship between the punctures or adverse events was identified. No serious complication was detected after the implantations during follow-up visits.

CONCLUSION

This study suggested that CT-guided percutaneous implantation of (125)I seeds in a pancreatic carcinoma was relatively safe and effective for treating unresectable pancreatic cancer.

ADVANCES IN KNOWLEDGE

The CT-guided percutaneous implantation of (125)I seeds in unresectable pancreatic cancer showed highly successful rates without serious complications.

摘要

目的

评估CT引导下经皮植入碘-125(¹²⁵I)粒子治疗胰腺癌的有效性和安全性。

方法

共纳入36例患者(男25例,女11例),平均年龄57岁(39 - 84岁),其中Ⅲ期胰腺癌27例,Ⅳ期胰腺癌9例。胰头肿瘤3个,胰体或胰尾肿瘤33个。肿瘤平均直径37.1 mm(15 - 65 mm)。采用18G穿刺针(长度150 - 200 mm)经前、外侧和后入路进行¹²⁵I粒子植入。然后,将¹²⁵I粒子装填并释放到病灶内。

结果

分别经前入路(23例)、外侧入路(9例)和后入路(4例)进行植入。植入过程中,每位患者穿刺3 - 14次,共记录穿刺164次。同时,共植入657枚粒子,每位患者平均植入25.27枚(12 - 50枚),成功率为100%。每枚粒子活度范围为0.55至0.65 mCi。1次穿刺发生主要不良事件,7次穿刺发生轻微不良事件。未发现穿刺次数与不良事件之间存在显著关联。随访期间植入后未检测到严重并发症。

结论

本研究表明,CT引导下经皮植入¹²⁵I粒子治疗胰腺癌对不可切除的胰腺癌相对安全有效。

知识进展

CT引导下经皮植入¹²⁵I粒子治疗不可切除胰腺癌成功率高,且无严重并发症。

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