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目的探讨超声引导下放射性粒子125I组织间永久植入治疗晚期结直肠癌的可行性、近期临床疗效及安全性。方法本研究纳入9例患者,均来自吉林大学中日联谊医院2012年10月至2014年10月期间收治的患者,均经严格的病例筛查。其中男5例,女4例;年龄46~78岁,中位年龄54岁;5例患者伴有疼痛症状。病灶总数14个:局部肿瘤复发灶1个,盆腔转移灶2个,肝转移灶8个,腹腔淋巴结转移灶3个。125I放射性粒子植入前CEA水平升高者6例。全部病例经CT、MRI检查或穿刺活检病理学检查证实为转移癌。采用超声实时引导植入125I放射性粒子,治疗后2个月复查CT,观察患者疼痛缓解程度、肿瘤局部控制情况及并发症发生情况。结果125I放射性粒子植入术后2个月复查CT,肿瘤完全缓解2列,部分缓解5例,稳定1例,进展1例;总有效者占7/9,疾病控制者占8/9。5例伴有疼痛患者治疗后疼痛均有所缓解。1例患者术后复查腹部CT发现腹腔内1枚金属粒子游走;术中及术后患者无严重并发症。结论超声引导下放射性粒子125I植入治疗晚期结直肠癌能明显缓解其临床症状,改善生活质量,并能有效控制转移灶,安全可行,且术后住院时间短,具有安全、有效、并发症发生率低等优势。
Objective To investigate the feasibility, short-term clinical efficacy and safety of ultrasound-guided permanent implantation of radioactive 125I tissue in the treatment of advanced colorectal cancer. Methods Nine patients were included in the study, all of whom were from the Chinese-Japanese Friendship Hospital of Jilin University between October 2012 and October 2014, and were screened strictly. There were 5 males and 4 females, aged from 46 to 78 years, with a median age of 54 years. Five patients had painful symptoms. The total number of lesions 14: a local tumor recurrence 1, pelvic metastasis 2, liver metastases 8, 3 abdominal lymph node metastasis. Sixteen patients with CEA elevated before radioactive 125I implantation. All cases by CT, MRI or biopsy biopsy confirmed metastatic cancer. Real-time guided ultrasound implantation of 125I radioactive particles, 2 months after treatment, CT review to observe the degree of pain relief in patients with local tumor control and complications. Results CT was performed 2 months after 125I radioactive seed implantation. The tumors were completely relieved in 2 cases, partially relieved in 5 cases, stabilized in 1 case and advanced in 1 case. The total effective rate was 7/9, and the rate of disease control was 8 / 9.5 Patients with pain associated with pain relief after treatment. One patient underwent abdominal CT scan and found one intra-abdominal metal particle walked. There were no serious complications during and after operation. Conclusion Ultrasound-guided radioactive 125I implantation for advanced colorectal cancer can significantly relieve its clinical symptoms, improve the quality of life, and effectively control metastases, safe and feasible, and short postoperative hospital stay, with safety, efficacy, complications Low rate and other advantages.