经导管肝动脉化疗栓塞联合125I粒子靶向内照射治疗肝脏恶性肿瘤的初步观察.pdf

《经导管肝动脉化疗栓塞联合125I粒子靶向内照射治疗肝脏恶性肿瘤的初步观察.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、·184·实用医学影像杂志2014年6月第15卷第3期JPMI，』ne，．．经导管肝动脉化疗栓塞联合I粒子靶向内照射治疗肝脏恶性肿瘤的初步观察曾国斌卢鑫林龙潜廖立安管玉婷【摘要】目的探讨经导管肝动脉化疗栓塞(transeatheterhepaticarterialchemoembolization，TACE)联合植入I粒子靶向内照射治疗肝脏恶性肿瘤的近中期疗效。方法本组24例中原发性肝癌18例、胆管细胞癌3例、大肠癌术后肝转移癌3例，共29个病灶。采取先进行1-3次TACE治疗，待病灶初步得到控制后在cT或彩色多普勒超声导向下植入I粒子，粒子植入

2、之前采用治疗计划系统(treatmentplanningsystem，TPS)模拟布源或遵循Halarism的I经验公式(mCi=Dax5)，求出术中所需I粒子的总活度及算出治疗粒子的数量。将粒子重点植入到肿瘤实质内碘油缺损区域及肿瘤边缘。结果随访6～23个月，半年生存率为100％，未出现严重的并发症。治疗后6个月肝内病灶肿瘤影像学评价，24例患者中，完全缓解(CR)4例，部分缓解(PR)13例，有效反应率(CR+PR)71％，稳定(NC)4例，进展(PD)3例。结论TACE联合植入I粒子靶向内照射治疗肝脏恶性肿瘤是安全、微创、有效的方法。【关键

3、词】肝肿瘤；碘放射性同位素；近距离放射疗法；化疗栓塞，治疗性PreliminaryobservationonbrachytherapybyTACEcombinedwithIodine-125seedsfortreatmentofhepaticcarcinomangGuobin,LuXin,LinLongqian,LiaoLi，GuanYuting．DepartmentofIntervention,PeoplesHospitalofMe~hou．Guangdong514031．China【Abstract1ObjectiveToinvestigat

4、etheshortandmidtermefficacyofbrachytherapyhytranscatheterhepatica~efialchemoembolization(TACE1combinedwithimplantationofIodine一125seedsfortreatmentofhepaticcarcino—ma．MethodsTherewere24patientswith29lesions．including18casesofprimaryhepaticcarcinoma．3casesofcholangiocarcinomaa

5、nd3casesofpostoperativehepaticmetastaseswithcolorectalcancer．TotreattheselesionswithTACEforonetothreetimes．thentoimplantIodine一125seedsundertheguidanceofCTorcolorDoppleruhrasoundwhenlesionshadbeenpreliminarilycontrolled．ThoseIodine．125seedsweremainlyimplantedintotheregionthat

6、lackoflipiodolwithintumorparenchymaandtumormarginaccordingtothetreatmentplanningsystem(TPS)ortheHalarismsexperiencedfunctionfmCi=Dax5)．mCiwasthetotalactivityofIodine．125seeds．AndthenumberofIo．dine一125seedsneededequalstothatoftotalactivitiesdividedbytheactivityofsingleparticle

7、．ResultsAherfollow．upfor6to23months．patientsshowednoseverercomplications；thehalGyearsurvivalratewas100％．Al1thepa．tientsunderwentfollowedCTscanaftersixmonths．CR．PR。NC。PDwereobtainedin4。13．4．3casesrespectively．AndtheresponsiverateofCR+PRwas71％．ConclusionBrachytherapybyTACEcombi

8、nedwithimplantationofIodine一125seedsiSasafe．minimallyinvasiveandeffe