【摘要】 目的探讨通过CT引导下同轴法经皮穿刺125I粒子植入治疗腹膜后淋巴结转移瘤的技术方法、安全性及临床价值。方法对21例腹膜后淋巴结转移瘤患者,采用同轴法125I粒子植入近距离放射治疗,所有患者术前采用治疗计划系统(TPS),术后CT验证放射性粒子种植后分布,观察治疗后患者腹痛、腹胀、肿瘤指标等改善情况及粒子植入术后靶淋巴结的局部反应。结果技术成功率100%,术后未出现消化道穿孔、放射性肠炎、大血管损伤出血等并发症。术后每隔1~2个月CT复查,术后6个月评价:完全缓解(CR)13例,部分缓解(PR)6例,病灶稳定(SD)2例,无病灶进展(PD),总有效率(CR+PR)90.5%。16例患者腹痛、腹胀均有不同程度减轻,14例患者肿瘤标志不同程度下降。结论 CT引导下同轴法组织间放射性粒子植入治疗腹膜后淋巴结转移瘤,疗效肯定、安全可靠,为腹膜后淋巴结转移瘤提供了微创治疗方法。更多还原

【Abstract】 Objective To investigate the method, safety and clinical value of CT-guided coaxial percutaneous125I seed implantation in treating retroperitoneal metastatic lymph nodes. Methods CT-guided coaxial percutaneous125I seed implantation, as interstitial brachytherapy, was carried out in 21 patients with retroperitoneal lymph node metastasis. Before operation therapeutic plan system(TPS) was used in all patients to design the distribution of radioactive particles, and after the procedure CT scanning was performed to verify the distribution of radioactive particles. After the treatment, the abdominal pain, abdominal distension, serum tumor marker levels and local reaction of the target lymph nodes were evaluated. Results The technical success rate was 100%, and after the operation no serious complications such as gastrointestinal perforation, radiation enteritis, vascular injury, bleeding, etc. occurred. Follow-up CT scanning was conducted once every 1-2 months. Six months after the treatment, complete remission(CR) was obtained in13 cases, partial remission(PR) in 6 cases, stable disease(SD) in 2 cases, and progression disease(PD)in none. The overall response(CR + PR) rate was 90.5%. The abdominal pain and abdominal distension were relieved in different degrees in 16 patients, and the serum tumor marker levels were decreased in different degrees in 14 patients. Conclusion For the treatment of retroperitoneal lymph node metastasis, CT-guided coaxial percutaneous125I seed implantation is effective, safe and reliable. This technique provides a new minimally-invasive treatment for retroperitoneal lymph node metastasis.更多还原