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目的观察放射性~(125)I粒子植入治疗转移性肝癌的临床疗效及并发症。方法回顾性收集应用~(125)I粒子植入治疗的22例转移性肝癌患者资料,所有患者术前应用治疗计划系统(TPS)制定植入计划,根据TPS计划在CT引导下行肝脏病灶~(125)I粒子植入术,术后行CT检查,将CT图像的DICOM格式图片传送到TPS系统,并进行术后剂量验证。分别于术后1、3、6、9、12个月行CT复查,进行临床疗效及并发症评价。结果 22例患者病灶总数为27个,中位肿瘤最长径3.4 cm(1.0~7.4 cm),病灶植入粒子数4~87颗,粒子活度1.85×107~2.96×107Bq(0.5~0.8 m Ci)。术后1个月,CR 11例,PR 6例,SD 5例,PD 5例,局控率(CR+PR+SD)为81.5%。术后3、6、9、12个月局控率分别为78.9%、76.9%、77.8%、66.7%。中位随访时间6个月(1~14个月),生存13例,死亡9例,中位生存时间12个月。粒子植入术后疼痛缓解率91.7%。术中出血7例(31.8%),恶心/呕吐3例(13.6%),术后发热1例(4.5%),粒子移位2例(9.1%)。结论 ~(125)I粒子植入术治疗转移性肝癌疗效确切,并发症少,是治疗肝脏恶性肿瘤的有效方法之一。
Objective To observe the clinical efficacy and complications of radioactive 125 I seed implantation in the treatment of metastatic liver cancer. Methods Twenty-two patients with metastatic HCC who were treated with ~ (125) I seed implantation were retrospectively collected. All patients underwent preoperative implantation planning with TPS and liver lesions under CT guidance under TPS 125) I particle implantation, postoperative CT examination, CT images DICOM format images sent to the TPS system, and postoperative dose verification. Respectively postoperative 1,3,6,9,12 months CT review, clinical efficacy and complication evaluation. Results The total number of lesions was 27 in 22 patients, the longest diameter was 3.4cm (1.0 ~ 7.4cm) in median tumor, the number of particles implanted in lesions was 4-87, and the activity of particles was 1.85 × 107 ~ 2.96 × 107Bq (0.5 ~ 0.8 m Ci). One month after surgery, there were 11 cases of CR, 6 cases of PR, 5 cases of SD, 5 cases of PD, and the control rate (CR + PR + SD) was 81.5%. Postoperative 3, 6, 9, 12 months, the local control rates were 78.9%, 76.9%, 77.8%, 66.7%. The median follow-up time was 6 months (range, 1 to 14 months), 13 patients survived, and 9 patients died. The median survival time was 12 months. The rate of pain relief after implantation was 91.7%. Intraoperative bleeding in 7 cases (31.8%), nausea / vomiting in 3 cases (13.6%), postoperative fever in 1 case (4.5%), particle displacement in 2 cases (9.1%). Conclusion ~ (125) I particle implantation for the treatment of metastatic liver cancer is effective and has few complications. It is an effective method for the treatment of hepatic malignancies.