【作者】 梁莉； 马力文； 王俊杰；

【Author】 Liang Li Ma Liwen Wang Junjie (The center of oncology,Peking University Third Hospital,Beijing,China,100083)

【机构】 北京大学第三医院肿瘤治疗中心；

【摘要】 目的:探讨放射性粒子组织间植入治疗对患者血象、肝功能、肾功能、T 细胞亚群和 NK 细胞活性的影响。方法:病理证实为恶性肿瘤的25例患者,超生引导下或术中植入放射性¹²⁵Ⅰ粒子。患者治疗前和治疗后3个月内监测血象、肝功能、肾功能及 T 细胞亚群、NK 细胞活性的变化。患者中位植入¹²⁵Ⅰ粒子数为18（3～68）颗,总放射活度为1．8mCi～ 23．8mCi（平均11．05±6．60mCi,中位放射活度为10．8mCi）。肿瘤匹配周边剂量65～145Gy。结果:治疗前白细胞、血红蛋白、血小板平均为（6．29±2．17）×10⁹/L、（122．75±17．32）g/L、 （219．85±117．51）×10⁹/L,治疗后1个月及3个月分别为（6．65±2．02）×10⁹、（115．23±29．56）g/L、 （257．95±159．97）×10⁹/L 和（8．67±3．77）×10⁹、（122．54±22．8）g/L、（185．07±89．39）×10⁹/L,统计学处理没有显著差别（P 分别为0．072、0．779和0．762）。患者 ALT、AST、BUN、Cr、CK 及 CK-MB 检测也未见异常（P 值分别为0．975、0．598、0．382、0．281、0．837、0．998）。胰腺癌患者总胆红素、直接胆红素在治疗后3个月有明显下降（P 值分别为0．009和0．007）．粒子治疗对患者 T 淋巴细胞亚群（CD3、CD4和 CD8）及 NK 细胞活性没有明显影响（P 值分别为0．752、 0．598、0．612、0．342）。结论:放射性粒子组织间植入治疗对患者重要脏器功能和免疫功能没有显著影响。是一种安全的肿瘤微创治疗技术,值得在临床上推广。更多还原

【Abstract】 OBJECTIVE:To explore the effect of interstitial brachytherapy with permanent seed implants on patients’ peripheral blood cells,liver function,renal function,T cells subgroups and the activity of natural killer cells （NK）.Methods:25 patients with malignant tumor were treated by interstitial brachytherapy with radioactive seed ¹²⁵I.We examined changes in numbers of blood cells,liver function,renal function,T cells function and NK cell activity before and after treatment in patients.Result:In 25 patients,the median numbers of ¹²⁵I seed were 18（3～68）.Radioactivity was form 1.8mCi to 23.8mCi（median radoactivity 10.8 mCi）.Before treatment,numbers of white cell,hemoglobin and platelet were （6.29±2.17）×10⁹/L, （122.75±17.32）g/L and （219.85±117.51）×10⁹/L,respectively.At the 1^st and 3^rd months after therapy,the number of white cell,hemoglobin and platelet were （6.65±7.02）×10⁹,（115.23±29.56） g/L,（257.95±159.97）×10⁹/L and （8.67±3.77）×10⁹,（122.54±72.8）g/L,（185.07±89.39）×10⁹/L, respectively.There was no significant difference （P=0.072,0.779 and 0.762）.We didn’t observe abnormity of patients’ ALT、AST、BUN、Cr、CK 及 CK-MB （P=0.975,0.598,0.382,0.281,0.837, 0.998）.The T-Bil and D-Bil of Patients with pancreatic carcinoma were significantly decreased within 3 months after treatment （P=0.009 and 0.007）.Interstitial brachytherapy had little side effect on T cell immunity and the activity of NK cells （P=0.752、0.598、0.612、0.342）. Conclusion:This study suggested that no side effect of interstitial brachytherapy with permanent seed implants on the function of human organs was observed.Seeds implantation could not injure immune function.Interstitial brachytherapy with permanent seed implants was a safe technique for cancer therapy.更多还原