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目的探讨CT引导下经胃入路125I粒子治疗腹膜后转移癌的安全性及初步疗效。方法回顾性分析了10例腹膜后转移癌患者,经充分的肠道准备,在CT引导下经皮经胃入路,采用1~3支粒子植入针植入125I粒子,活度0.3~0.7m Ci,术后验证周边剂量(D90)为40~70 Gy,观察临床疗效及并发症情况。结果 10例均顺利完成手术,随访时间1~9个月,CR 2例,PR 4例,SD 3例,PD 1例。7例术前腹部疼痛,术后不同程度缓解。2例术前不能进食,术后可进少量半流汁,1例肠梗阻术前无排便,术后排出成形粪便。术后所有患者均出现穿刺部位表皮轻微疼痛,无需特殊处理;1例术后1个月出现穿刺针道皮下转移;均未出现出血、腹膜炎、放射性皮肤损伤、粒子移位等并发症。结论 CT引导下经胃入路125I粒子治疗腹膜后转移癌安全可行。
Objective To investigate the safety and primary efficacy of CT-guided 125I particle transabdominal approach in the treatment of retroperitoneal metastatic carcinoma. Methods A retrospective analysis of 10 cases of retroperitoneal metastatic cancer patients, after adequate bowel preparation, CT-guided percutaneous transabdominal approach, the use of 1 ~ 3 particles implanted needle 125I particles activity 0.3 ~ 0.7 m Ci. The peripheral dose (D90) was 40-70 Gy after operation, and the clinical efficacy and complications were observed. Results All the 10 cases were successfully performed. The follow-up time ranged from 1 to 9 months. There were 2 cases of CR, 4 cases of PR, 3 cases of SD and 1 case of PD. Seven cases of preoperative abdominal pain, postoperative relief to varying degrees. 2 cases can not eat before surgery, after surgery can enter a small amount of half-juice, 1 case of intestinal obstruction without defecation before surgery, excretion of feces after discharge. All patients showed minor pain in the epidermis of the puncture site without any special treatment. One patient had subcutaneous needle puncture at 1 month after operation. No bleeding, peritonitis, radioactive skin injury or particle displacement were found. Conclusion It is safe and feasible to treat retroperitoneal metastases by transabdominal 125I particles guided by CT.