吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (05): 963-966.doi: 10.13481/j.1671-587x.20170520

• 临床研究 • 上一篇    下一篇

热疗联合125I粒子治疗复发性直肠癌的近期疗效评价

王溪, 韩今华, 李云峰, 杨艳明   

  1. 吉林大学第二医院放疗科, 吉林 长春 130041
  • 收稿日期:2016-11-30 出版日期:2017-09-28 发布日期:2017-09-29
  • 通讯作者: 杨艳明,副主任医师(Tel:0431-88796179,E-mail:yym180@163.com) E-mail:yym180@163.com
  • 作者简介:王溪(1963-),男,辽宁省辽阳市人,主管技师,主要从事肿瘤放射治疗学技术方面的研究。
  • 基金资助:
    国家自然科学基金青年基金资助课题(81502751)

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

WANG XI, HAN Jinhua, LI Yunfeng, YANG Yanming   

  1. Department of Radiotherapy, Second Hospital, Jilin University, Changchun 130041, China
  • Received:2016-11-30 Online:2017-09-28 Published:2017-09-29

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-1t=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