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目的探讨放射性~(125)Ⅰ粒子植入治疗结肠直肠癌肝转移(CRLM)的疗效及安全性。方法为24例化疗失败或不能耐受化疗的CRLM患者共计65个肝转病灶行CT引导下植入~(125)Ⅰ粒子,粒子的放射性活度介于0.5～0.7 mCi,每例患者接种的粒子数为18～109枚,最小边缘剂量为110～160 Gv植入后进行质量验证。结果在6个月的随访中,肿瘤的最长径基线和从术前(7.21±3.28)cm降到术后3个月时的(4.47±3.34)和6个月时的(3.94±2.05)cm,差异有统计学意义(P<0.05)。CEA南术前的(293±89)ng/ml降至术后3、6个月的(198±103)ng/ml、(155±6 1)ng/ml,差异有统计学意义(P<0.05)。未出现与治疗相关的死亡。1、2年生存率分圳为87.5%和75.0%。结论 CT引导下~(125)Ⅰ粒子植入治疗CRLM微创、安全,近期疗效确切,远期疗效有待观察。
Objective To investigate the efficacy and safety of radioactive (125) Ⅰ particle implantation in the treatment of colorectal cancer liver metastasis (CRLM). METHODS: Totally 65 hepatorenal lesions in 24 CRLM patients who failed chemotherapy or could not tolerate chemotherapy underwent CT-guided implantation of 125I particles with radioactivity ranging from 0.5 to 0.7 mCi. Each patient was vaccinated The number of particles ranged from 18 to 109 and the minimum marginal dose was 110 to 160 Gv for quality verification after implantation. Results At the 6-month follow-up, the longest tumor diameter baseline was significantly lower for the tumor from baseline (7.21 ± 3.28) cm to (4.47 ± 3.34) at 3 months and (3.94 ± 2.05) at 6 months cm, the difference was statistically significant (P <0.05). The difference was statistically significant between (293 ± 89) ng / ml preoperative CEA and (198 ± 103) ng / ml and (155 ± 6 1) ng / ml 3 and 6 months postoperatively (P < 0.05). No treatment-related deaths occurred. The 1-year and 2-year survival rates were 87.5% and 75.0% respectively. Conclusions The CT-guided implantation of 125I seeds for minimally invasive treatment of CRLM is safe and has short-term curative effect. The long-term therapeutic effect remains to be seen.