热疗联合125I粒子治疗复发性直肠癌的近期疗效评价

doi:10.13481/j.1671-587x.20170520

摘要/Abstract

摘要： 目的：通过比较复发性直肠癌患者治疗前、后影像学和血清中癌胚抗原（CEA）以及术后随访结果，评价热疗联合¹²⁵I放射性粒子治疗直肠癌的有效性。方法：手术且放疗后行CT引导下¹²⁵I放射性粒子植入术（20例手术治疗患者，1例患者无法耐受热疗退出），术前应用放射性粒子治疗计划系统（TPS）制定粒子植入计划，粒子间距为1.0 cm，植入后立即复查CT，再行剂量验证，植入粒子数量为12~58颗，每颗粒子放射性活度为0.5 mCi，肿瘤周边匹配剂量为90~140 Gy。射频热疗，每次60 min，维持温度43℃，每周2次，连续3周。治疗后随访3个月，通过影像学结果和血清中CEA水平变化评价有效率，并评估尿频、尿痛、血尿和直肠出血等并发症。结果：与治疗前比较，随访6个月后影像学结果显示肿瘤缩小；患者治疗后血清中CEA水平由治疗前（30.25±8.32） mg·L^-1降低到（11.89±5.22） mg·L^-1（t=13.158，P < 0.01）；局部有效率94.7%（18/19），疼痛缓解率为94.4%（17/18）；治疗前NRS评分中位数为6（4，7）分，治疗后NRS评分中位数为1（0，3）分，治疗前后比较差异有统计学意义（P < 0.01）。随访期间患者未出现尿频、尿痛、血尿和直肠出血等并发症。结论：热疗联合¹²⁵I放射性粒子植入对复发性直肠癌具有较好的临床效果，是复发性直肠癌有效的综合治疗手段。

关键词: 热疗, ¹²⁵I放射性粒子, 直肠肿瘤, 复发

Abstract: Objective: To evaluate the clinical efficacy of thermal-therapy combined with ¹²⁵I radioactive particles by comparing the results of preoperative and postoperative images,serum carcino-embryonic antigen(CEA) and following-up after treatment of the patients with recurrent rectal cancer. Methods: Nineteen rectal cancer patients with postoperative recurrence after radiotherapy were treated with ¹²⁵I implantation guided by CT (20 cases were treated with operation, but 1 patient was exited who couldn't tolerate the thermal-therapy). Radioactive particle treatment planning system (TPS) was used to make the plan before the particle implantation, and the distance of the particle was 1.0 cm; all patients received CT scanning and were quantificationally evaluatated after implantation; the number of seeded particles was about 12-58, the radioactivity of the ¹²⁵I particle was 0.5 mCi, and the matching dose surrounding the tumor was 90-140 Gy. All patients were treated with microwave thermal-therapy after particle implantation, 60 min per time, lasting the temprature at 43℃, twice per week, for three weeks. And the patients were followed up after treatment for 3 months, the efficacy was evaluated by image and CEA results, and the urinary frequency, dysuria, hematuria and rectal bleeding were evaluated. Results: Compred with before treatment, after following up for 6 months, the image results showed that the tumor volume was reduced, and the blood CEA level of all patients were decreased from (30.25±8.32)mg·L^-1 to (11.89±5.22) mg·L^-1 (t=13.158,P<0.01);the local efficacy was 94.7% (18/19),and the pain relief rate was 94.4% (17/18);the NRS median was 6(4,7)before treatment,and it was 1(0,3) after treatment, there was significant difference (P<0.001).There were no frequent urination, urinary pain, hematuria, rectal bleeding and other complications in all patients. Conclusion: Thermal-therapy combined with ¹²⁵I radioactive particle implantation has good curative effects on the recurrent rectum cancer, and is effective means for recurrent rectum cancer treatment.

Key words: rectal neoplasma, thermal-therapy, ¹²⁵I radioactive particles, recurrence

中图分类号:

R735.37

王溪, 韩今华, 李云峰, 杨艳明. 热疗联合¹²⁵I粒子治疗复发性直肠癌的近期疗效评价[J]. 吉林大学学报(医学版), 2017, 43(05): 963-966.

WANG XI, HAN Jinhua, LI Yunfeng, YANG Yanming. Observation on short-term efficacy of thermal-therapy combined with ¹²⁵I particles in treatment of recurrent rectal cancer[J]. Journal of Jilin University Medicine Edition, 2017, 43(05): 963-966.

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热疗联合¹²⁵I粒子治疗复发性直肠癌的近期疗效评价

Observation on short-term efficacy of thermal-therapy combined with ¹²⁵I particles in treatment of recurrent rectal cancer

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