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目的探讨 CT 导引下瘤体内~(125)Ⅰ粒子置入治疗兔 VX_2肝转移癌的疗效及其病理改变,为~(125)Ⅰ粒子临床应用中合理化治疗方案的取得提供理论依据。方法新西兰兔32只制备成 VX_2肝转移癌模型,完全随机法分为4组,每组8只,依据术前治疗计划系统(TPS)设计在 CT 引导下置入不同活度粒子,分别为:37.0、25.9和14.8 m Bq,对照组置入粒子空壳。观察置入后1周、2周、1个月、2个月和3个月各组肿瘤的大小、活性、影像和病理组织形态学的变化。结果治疗组自然生存期(88±12)d 明显高于对照组(22±7)d。治疗3个月后,治疗组平均肿瘤体积分别为:37.0 mBq 组(0.06±0.02)cm~3、25.9 mBq 组(0.21±0.05)cm~3、14.8 mBq 组(1.74±1.22)cm~3,重复测量方差分析及 LSD 两两比较表明37.0 mBq 与25.9 mBq 组间差异无统计学意义(t=0.35,P>0.05),但均低于14.8 mBq组(t 值分别为2.59、2.24,P值均<0.05)。治疗后增强 MR 扫描显示37.0 mBq 组强化消失5例,25.9 mBq 组强化消失4例,而14.8 mBq 组强化消失仅1例。病理检查37.0 mBq 组及25.9 mBq 组大部分瘤巢缩小至消失,疗效优于14.8 mBq 组,但在放射粒子对正常肝组织影响方面37.0 mBq 组较其他治疗组严重。结论短期疗效证明,25.9 mBq 的~(125)Ⅰ粒子可对高增殖活性的肝恶性肿瘤起到良好的控制作用,并且对正常肝组织的损伤程度较小。
Objective To investigate the curative effect and pathological changes of ~ (125) Ⅰ particles in the treatment of rabbit VX_2 liver metastases under CT guidance and to provide a theoretical basis for the rational treatment of 125 125 Ⅰ particles in clinical application. Methods Thirty-two New Zealand rabbits were divided into 4 groups (n = 8). All the 8 rabbits were divided into 4 groups according to the preoperative planning system (TPS) 37.0, 25.9 and 14.8 m Bq, respectively. The control group was placed in the shell of the particle. The changes of tumor size, activity, imaging and histopathology were observed at 1 week, 2 weeks, 1 month, 2 months and 3 months after implantation. Results The natural life of the treatment group (88 ± 12) d was significantly higher than that of the control group (22 ± 7) d. After 3 months of treatment, the mean tumor volume in the treatment group was 37.0 mBq (0.06 ± 0.02) cm 3 and 25.9 mBq (0.21 ± 0.05) cm 3 and 14.8 mBq (1.74 ± 1.22) cm 3, respectively Repeated measures ANOVA and LSD comparison showed that there was no significant difference between 37.0 mBq and 25.9 mBq (t = 0.35, P> 0.05), but both were lower than 14.8 mBq group (t = 2.59,2.24, P = All <0.05). Enhanced MRI scanning showed that in 37.0 mBq group, there were 5 cases of enhancement disappearance, 25.9 mBq group disappeared in 4 cases, and 14.8 mBq group disappeared in 1 case. Pathological examination Most neoplasms in 37.0 mBq group and 25.9 mBq group shrank to disappear, and the effect was better than that of 14.8 mBq group. However, 37.0 mBq group was significantly more severe than the other treatment groups in the influence of radioactive particle on normal liver tissue. Conclusion Short-term results show that 25.9 mBq of ~ (125) Ⅰ particles can play a good role in the control of highly proliferative hepatic malignancies and have less damage to normal liver tissue.