1.0T开放型磁共振引导经皮穿刺125I放射性粒子植入治疗晚期胰腺癌

doi:10.6040/j.issn.1671-7554.0.2016.1476

摘要/Abstract

摘要： 目的评价1.0T开放式MRI引导下经皮¹²⁵I放射性粒子植入治疗不可手术切除的晚期胰腺癌的可行性、安全性与有效性。方法选取31例无法外科手术切除的晚期胰腺癌患者,术前行MRI引导下穿刺活检,病理证实为胰腺癌。制定治疗计划系统(TPS),设定处方剂量(PD)120~160 Gy,D90>90%PD,V100>90%,V200<50%,在1.0T开放式磁共振引导下,结合呼吸门控技术行放射性¹²⁵I粒子植入。术后24 h内实施TPS剂量验证。结果 31例患者均顺利穿刺并按术前计划植入¹²⁵I粒子,手术成功率100%。术后TPS验证,D90范围91%~112%PD,V100范围92%~106%,V200范围21%~49%。术后第1、3、6、12个月复查,以后每1年复查1次,中位生存时间为14.7个月,Ⅲ期和Ⅳ期的的中位生存时间分别为16.3个月和5.9个月。有效率83.8%,局部控制率93.5%。疼痛缓解有效率91.6%。未见胰腺炎、胰瘘、肠瘘、腹腔出血等严重并发症。结论 1.0T磁共振引导经皮放射性¹²⁵I粒子植入治疗不可手术切除的晚期胰腺癌可行、且安全有效。

关键词: ¹²⁵I粒子, 磁共振成像, 不可手术切除, 胰腺癌

Abstract: Objective To evaluate the feasibility, safety and efficacy of 1.0T open MRI-guided ¹²⁵I seeds percutaneous implantation in the treatment of unresectable advanced pancreatic cancer. Methods A group of 31 patients with confirmed unresectable advanced pancreatic cancer were enrolled. The treatment plan was designed with treatment plan system(TPS)before implantation. With prescription dose(PD)being 120~160 Gy, D90>90%PD, V100>90%, V200<50%, under the 1.0T open MRI guidance, ¹²⁵I seeds were implanted. Dosimetric verification was conducted within 24 h after surgery. Results All 31 procedures were successful. After implantation, TPS showed D90, V100 and V200 ranged 91%-112%PD, 92%-106%, and 21%-49%, respectively. The patients were rechecked 1, 3, 6 and 12 months after operation, and after that once a year. The median survival was 14.7, 16.3 and 5.9 months for the whole group, for patients with stage Ⅲ cancer and stage Ⅳ cancer. The effective rate was 83.8%, local control rate was 93.5%, and pain relief rate was 91.6%. No serious complications such as pancreatitis, pancreatic fistula, intestinal fistula and hemorrhage were observed. Conclusion 1.0T open MRI-guided ¹²⁵I seeds percutaneous implantation is safe, feasible and effective for unresectable advanced pancreatic cancer.

Key words: ¹²⁵I seeds, Unresectable, Pancreatic cancer, Magnetic resonance imaging

中图分类号:

R735.9

许玉军,柳明,何祥萌,李成利. 1.0T开放型磁共振引导经皮穿刺¹²⁵I放射性粒子植入治疗晚期胰腺癌[J]. 山东大学学报（医学版）, 2017, 55(2): 21-25.

XU Yujun, LIU Ming, HE Xiangmeng, LI Chengli. 1.0T open MRI-guided ¹²⁵I seeds percutaneous implantation for advanced pancreatic cancer[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(2): 21-25.

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1.0T开放型磁共振引导经皮穿刺¹²⁵I放射性粒子植入治疗晚期胰腺癌

1.0T open MRI-guided ¹²⁵I seeds percutaneous implantation for advanced pancreatic cancer

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