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目的评价CT导引下放射性125I粒子永久组织间植入治疗腹膜后淋巴结转移癌的临床应用价值。方法男19例,女9例,年龄28～81岁,中位年龄56岁。其中肝癌术后转移7例,胰腺癌术后转移5例,胃癌术后转移3例,结直肠癌术后转移1例,卵巢癌术后转移1例,食管癌术后转移2例。按WHO疼痛程度分级标准,Ⅰ级5例,Ⅱ级13例,Ⅲ级10例;均药物止痛效果欠佳。均在CT导引下行125I粒子永久组织间植入治疗。结果 28例疼痛患者中,1周后显效16例,有效7例,无效5例,有效率82.14%。1个月后显效19例,有效5例,无效4例,有效率85.71%。3个月后显效22例,有效4例,无效2例,有效率92.86%。6个月后显效21例,有效6例,无效1例,有效率96.43%。结论 CT导引下经皮穿刺放射性125I粒子永久组织间植入治疗腹膜后淋巴结转移癌性疼痛是一种安全有效的微创治疗方法,对控制患者疼痛症状有良好的近期临床疗效。
Objective To evaluate the clinical value of CT-guided permanent 125I radioactive seed implantation in the treatment of retroperitoneal lymph node metastases. Methods 19 males and 9 females, aged 28 to 81 years, with a median age of 56 years. There were 7 cases of postoperative metastasis of liver cancer, 5 cases of postoperative metastasis of pancreatic cancer, 3 cases of postoperative metastasis of gastric cancer, 1 case of postoperative metastasis of colorectal cancer, 1 case of postoperative metastasis of ovarian cancer and 2 cases of postoperative metastasis of esophageal cancer. According to the WHO grading standards of pain, Ⅰ grade in 5 cases, Ⅱ grade in 13 cases, Ⅲ grade in 10 cases; both drugs poor analgesic effect. CT-guided 125I permanent implantation of particles between the implant treatment. Results Among the 28 patients with pain, 16 cases were markedly effective after 1 week, 7 cases were effective, 5 cases were ineffective and the effective rate was 82.14%. After 1 month, 19 cases were markedly effective, 5 cases were effective, 4 cases were ineffective, and the effective rate was 85.71%. After 3 months, 22 cases were markedly effective, 4 cases effective, 2 cases ineffective, and the effective rate was 92.86%. After 6 months, 21 cases were markedly effective, 6 cases effective, 1 case ineffective, and the effective rate was 96.43%. Conclusion The CT-guided percutaneous 125I radioactive seed implantation of permanent interstitial tissue in the treatment of retroperitoneal lymph node metastatic cancer pain is a safe and effective minimally invasive treatment of patients with pain control symptoms have a good short-term clinical efficacy.