碘125放射粒子组织间植入治疗恶性肿瘤.pptVIP

生物学优势（外放疗相比） 肿瘤局部治疗的持续时间长 放射治疗的剂量较低 对周围正常组织的损伤小 对肿瘤细胞的杀伤力强 HE staining 适应症 实体瘤（如前列腺癌）的根治性治疗 实体瘤术后残余组织的预防性治疗 转移性肿瘤病灶或术后孤立性肿瘤转移灶而失去手术价值者 无法手术的原发肿瘤的姑息性治疗 禁忌证 放射性治疗不宜(如血液病等)及有麻醉禁忌等 病灶范围广泛 恶液质、全身衰竭 肿瘤部位有活动性出血、坏死或溃疡 严重糖尿病 Pre-implant CT scan (Case Two) Post-implant CT scan Post-implant CT scan Pre-implant CT scan (Case Three)  Post-implant CT scan Pre-implant CT scan (Case Four)  Post-implant CT scan Post-implant CT scan 国内临床尚有许多问题需要解决 临床应用适应症选择标准不一，造成不同医院应用放射性粒子植入治疗技术后疗效评价缺乏标准，尤其在放射性粒子治疗肿瘤的过程中，现在面临的缺乏行业管理标准和操作技术规范 如不同增殖速率的肿瘤如何选择不同放射性核素,以获得最大的杀伤效应 粒子种植治疗仍是局部治疗手段，是外科和外放疗的补充和延伸，单纯放射性粒子植入治疗并不能解决所有肿瘤治疗问题，如何合理、科学地与外科、外放疗和化疗结合，最大限度发挥粒子植入治疗的优势 展 望 由于放射性粒子植入治疗恶性肿瘤创伤小，靶区剂量分布较均匀和对周围正常组织损伤较小等特点，在临床应用展现了广阔的前景 同样放射性粒子植入技术治疗肿瘤需要多学科联合，特别需要准确的治疗计划、娴熟的治疗技术和严谨的术后质量评估 Complications No serious complications encountered 2 seeds of radioactive 125I found to migrate to liver in 2 patients Leukopenia and renal function impairment were found in 4 patients of drug-seeds combination group Iodine-125 Therapy in advanced Pancreatic Cancer Discussion Percutaneous image-guided seed implantation has attracted increasing attention Extensive experiences with this technique had been collected targeting liver and lung malignancies The most commonly used isotope is 125I , and 125I placement has become a routine treatment for recurrent tumors at various sites in our institution ZM. Wang MD, Shanghai Ruijin Hospital Technical points during the procedure Patients fasted for 24 hours Ensure steady breath movement during the procedure Pancreatic secretion was inhibited Transgress stomach is safer than intestine, avoiding colon especially when using large-bore needles For patients with jaundice, do PTCD first Immediate CT scan post implantation was done to verify the distribution of the seeds ZM. Wang MD, Shanghai Ruijin Hospital Drug-seeds combined therapy There is data suggests that local control rates can be enhanced by the addi