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目的 探讨 ＣＴ引导下１２５Ｉ粒子植入治疗Ⅲ ～Ⅳ期胃癌淋巴结转移的安全性及疗效。方法 回顾性分析２００５年 １月至 ２０１６年 ５月晚期胃癌淋巴结转移 １５例患者的治疗情况，其中淋巴结直径≤５ｃｍ６例、＞５ｃｍ９例，ＣＴ引导下植入１２５Ｉ粒子，活度 ０．３～０．７ｍＣｉ，术后验证 Ｄ９０、Ｖ１００、Ｖ１５０，且与术前进行对比，观察病灶大小及并发症。结果 １５例患者均手术顺利，随访时间 ６～１８个月，６个月局部控制率为 ９３．３％、有效率为 ７３．３％，６、１２个月生存率分别为 １００％、３１％。Ｄ９０、Ｖ１００、Ｖ１５０术前与术后各指标比较差异均无统计学意义（Ｐ值分别为０．１００、０．６２８、０．９７１）。未见大出血、胃穿孔、肠道感染、骨髓抑制、皮肤黏膜反应等并发症。结论 ＣＴ引导下１２５Ｉ粒子植入治疗Ⅲ ～Ⅳ期胃癌淋巴结转移近期疗效较好，是一种安全可行的方法。
Objective To investigate the safety and efficacy of CT-guided 125I seed implantation in the treatment of stage Ⅲ-Ⅳ gastric cancer lymph node metastasis. Methods The clinical data of 15 patients with advanced gastric cancer with lymph node metastasis from January 2005 to May 2016 were retrospectively analyzed. There were 6 cases with lymph node ≤5cm in diameter and> 5cm in 9 cases. 125I seeds were implanted under CT guidance and the activity ranged from 0.3 to 0 .7mCi, postoperative D90, V100, V150, and compared with preoperative to observe the size and complications of the lesion. Results All the 15 patients were operated successfully. The follow-up time ranged from 6 to 18 months. The local control rate was 93.3% at 6 months, the effective rate was 73.3%. The survival rates at 6 and 12 months were 100% and 31% . D90, V100, V150 between the preoperative and postoperative indicators were no significant difference (P values were 0.100,0.628,0.971). No major bleeding, gastric perforation, intestinal infection, bone marrow suppression, skin and mucous membrane reactions and other complications. Conclusion CT-guided 125I seed implantation in the treatment of stage Ⅲ ~ Ⅳ lymph node metastasis of gastric cancer has a good short-term effect, is a safe and feasible method.