孙琼 1张家兴 2徐斌 1马艳艳 1董小庆 1张凯 1王道超1
作者信息
- 1. 宿迁市工人医院 江苏 宿迁 223800
- 2. 同济大学附属上海第十人民医院
- 折叠
摘要
Abstract
Objective:To evaluate the clinical effect of CT-guided coaxial method of 125I seed implantation in patients with cancer pain in the abdominal cavity and retroperitoneal lymph node metastatic tumors and its clinical effect.Method:22 cases with abdominal pain and retroperitoneal lymph node metastases(33 metastatic foci,size 3~15 cm),125I particles were implanted with preoperative TPS plan,CT guided coaxial method was performed during the operation,and the prescription dose was 80-100 Gy.Immediately after CT examination was introduced into TPS,and to verify the quality of particle implantation.The changes of pain indicators and the short-term effect were respectively evaluated with visual analogue scale (VAS) at the 5 points of time (1,7,30,60 and 90 d after treatment). All the patients were followed up and were kept under observation for clinical symptoms,imaging (tumor volume) changes,related complications,evaluation of the recent efficacy of tumor.Result:In 22 patients,the results of real-time TPS validation:the technical success rate was 86.4%(19/22),that is,19 cases of particle implantation quality is very good,3 cases of poor quality of implant,1 case of D90<MPD,1 case of TVR<1,1 case of implanted particles dose of uneven degree >20%PD.Simulation of the score of each monitoring point pain pain visual 125I particle implantation(VAS) were lower than those before treatment(P<0.01), after 1,7,30,60,90 d implantation pain rates were 72.73%,86.36%,90.91%,81.82%,72.73%.Clinical efficacy CR 3 cases,9 cases of PR,SD 7 cases,3 cases of PD.The total objective response rate (CR+PR) was 54.55%,disease benefit rate (CR+PR+SD) for 86.36%.Followed up for 5 to 24 months(average 15.6 months),the median survival time for 12.8 months,6 months and 1 year survival rates were 95.5%(21/22) and 77.3%(17/22),no serious complications. Conclusion:125I radioactive seed interstitial implantation in treatment of cancer pain in the abdominal cavity and retroperitoneal lymph node metastasis of the rapid onset of effect,no adverse reactions,worthy of further clinical promotion.关键词
肿瘤转移/淋巴结/腹部/CT引导/同轴法/125I/近距离放射疗法Key words
Tumor metastasis/Lymph node/Abdomen/CT-guided/Coaxial method/125I/Brachytherapy分类
医药卫生
