论文部分内容阅读
背景:放射性粒子植入近距离内照射治疗恶性肿瘤是一种新的放疗手段,随着粒子植入治疗计划系统的出现和CT、超声引导下精确定位系统的逐步完善,使放射性粒子组织间植入治疗得到进一步应用。目的:评价CT导向下瘤体内125I粒子植入治疗恶性肿瘤的操作方法、可行性、安全性及其技术特征。设计:前后对照观察。单位:合肥市第一人民医院。对象:选择2004-01/2005-03合肥市第一人民医院收治的不适合外科手术治疗的恶性肿瘤患者21例,共26个病灶,其中原发性病灶9个,转移性病灶17个。方法:在CT导向下将125I粒子植入恶性肿瘤病灶内,采用治疗计划系统计算布源,125I粒子的放射性活度为22,26,30,33MBq/粒,病灶中心选择较大活度的粒子,病灶边缘及重要器官附近选择较小活度的粒子,较大活度的粒子间距为1.5cm,较小活度的粒子间距为1.0cm。主要观察指标:观察粒子在瘤体内的分布、有无并发症及植入粒子后病灶大小变化。结果:①21例粒子植入均顺利完成,术中无并发症发生,粒子在病灶内的分布与植入前计划基本一致。21例全部进入结果分析。②每个瘤体内植入125I粒子数为5￣40粒(平均14粒)。10例恶性骨肿瘤患者植入术后疼痛均有明显缓解。术后随诊复查CT,18个病灶明显缩小,4个病灶内出现坏死组织,4个病灶大小无明显变化。③11例14个病灶随访5～7个月,植入后平均病灶大小明显小于植入前(1.84cm比3.41cm,t=5.7237,P<0.001);10例12个病灶随访8～10个月,植入后平均病灶大小也明显小于植入前(1.96cm比3.43cm,t=5.5778,P<0.002)。结论:CT导向下瘤体内植入125I粒子近距离放射治疗恶性肿瘤是一种安全、有效治疗方法。
BACKGROUND: Radionuclide implantation in brachytherapy for malignant tumor is a new radiotherapy method. With the appearance of particle implantation treatment planning system and CT, ultrasound-guided accurate positioning system is gradually improved, Into treatment has been further applied. OBJECTIVE: To evaluate the operation, feasibility, safety and technical characteristics of CT guided 125I seed implantation in the treatment of malignant tumors. Design: Control before and after observation. Unit: Hefei First People’s Hospital. PARTICIPANTS: Twenty-one patients with malignant tumors not suitable for surgical treatment were selected from the First People’s Hospital of Hefei City from January 2004 to March 2005. There were 26 lesions, including 9 primary lesions and 17 metastatic lesions. Methods: 125I seeds were implanted into malignant tumor lesions under the guidance of CT. The cloth source was calculated by the treatment planning system. The radioactivity of 125I particles was 22, 26, 30, 33MBq / particle, and the center of lesion selected the larger activity particles , The edge of the lesion and important organs near the select smaller activity particles, the larger the activity of the particle spacing 1.5cm, the smaller the activity of the particle spacing 1.0cm. MAIN OUTCOME MEASURES: To observe the distribution of particles in the tumor, with or without complications and changes in lesion size after implantation of the particles. Results: ① All the 21 cases were successfully completed with no complications during the operation. The distribution of the particles within the lesion was basically the same as that before implantation. 21 cases all entered the result analysis. The number of 125I seeds implanted in each tumor was 5 ~ 40 (average 14). Ten cases of malignant bone tumor patients with postoperative pain were significantly relieved. Postoperative follow-up examination CT, 18 lesions were significantly reduced, 4 lesions within the necrotic tissue, 4 lesions no significant change in size. ③Fourteen lesions of 11 cases were followed up for 5 to 7 months. The mean lesion size after implantation was significantly smaller than that before implantation (1.84cm vs 3.41cm, t = 5.7237, P <0.001); 10 cases of 12 lesions were followed up for 8-10 months The average lesion size after implantation was also significantly smaller than that before implantation (1.96 cm vs 3.43 cm, t = 5.5778, P <0.002). CONCLUSION: CT-guided implantation of 125I brachytherapy in malignant tumors is a safe and effective treatment.