CT引导下125I粒子植入治疗晚期胃癌淋巴结转移

doi:10.6040/j.issn.1671-7554.0.2016.1668

摘要/Abstract

摘要： 目的探讨CT引导下¹²⁵I粒子植入治疗Ⅲ~Ⅳ期胃癌淋巴结转移的安全性及疗效。方法回顾性分析2005年1月至2016年5月晚期胃癌淋巴结转移15例患者的治疗情况,其中淋巴结直径≤5 cm 6例、>5 cm 9例, CT引导下植入¹²⁵I粒子,活度0.3~0.7 mCi,术后验证D90、V100、V150,且与术前进行对比,观察病灶大小及并发症。结果 15例患者均手术顺利,随访时间6~18个月,6个月局部控制率为93.3%、有效率为73.3%,6、12个月生存率分别为100%、31%。D90、V100、V150术前与术后各指标比较差异均无统计学意义(P值分别为0.100、0.628、0.971)。未见大出血、胃穿孔、肠道感染、骨髓抑制、皮肤黏膜反应等并发症。结论 CT引导下¹²⁵I粒子植入治疗Ⅲ~Ⅳ期胃癌淋巴结转移近期疗效较好,是一种安全可行的方法。

关键词: 疗效, 胃肿瘤, 近距离放射治疗, 淋巴结转移

Abstract: Objective To evaluate the safety and effect of ¹²⁵I seed implantation for lymph node metastases in patients with gastric cancer of Ⅲ-Ⅳ stage. Methods The data of 15 gastric cancer patients with lymph node metastases treated by CT-guided ¹²⁵I seed implantation were retrospectively studied from January 2005 to May 2016. Lymph nodes with diameter ≤5 cm in six(33.3%)lesions, >5 cm were observed in nine(66.6%)lesions. Under CT guided implanted ¹²⁵I seed with the activity of 0.3-0.7 mci,postplan was performed after the operation, the D90, V100, V150 pre and post operation were collected and compared. Six months after the treatment reexamination was employed, including lesion size changes and complications. Results The follow-up ranged from 6 to 18 months.The 6 -month local control was 93.3%, the effective rate was 73.3%, The 6-, 12- month of survival rates was 100% and 31%, respectively. The difference of all data between pre and post operation was not statistically significant(P=0.10, P=0.628, P=0.971)in the D90, V100, V150. No major complications such as massive hemorrhage, Gastric perforation,intestinal infection, bone marrow suppression, Reaction of skin and other related to the procedure occurred during the therapy. Conclusion CT guided radioactive ¹²⁵I seed implantation for lymph node metastases in patients with gastric cancer of Ⅲ-Ⅳ stage was a safe and feasible method.

Key words: Brachytherapy, Lymph node metastases, Gastric cancer, Effect

中图分类号:

R816.5

底学敏,牛书雷,赵静,杜随,于慧敏,张宏涛,王娟. CT引导下¹²⁵I粒子植入治疗晚期胃癌淋巴结转移[J]. 山东大学学报（医学版）, 2017, 55(9): 79-84.

DI Xuemin, NIU Shulei, ZHAO Jing, DU Sui, YU Huimin, ZHANG Hongtao, WANG Juan. CT-guided ¹²⁵I seed implantation for lymph node metastases in patients with gastric cancer of later stage[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(9): 79-84.

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CT引导下¹²⁵I粒子植入治疗晚期胃癌淋巴结转移

CT-guided ¹²⁵I seed implantation for lymph node metastases in patients with gastric cancer of later stage

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