碘125粒子植入治疗恶性淋巴结肿大临床价值.docVIP

碘125粒子植入治疗恶性淋巴结肿大临床价值[摘要] 目的 介绍CT或B超引导下碘125粒子永久植入治疗淋巴结转移或淋巴瘤所致淋巴结肿大的技术方法并评价其临床价值。方法 31例恶性肿瘤转移淋巴结，8例淋巴瘤行CT或B超引导下碘125粒子植入，依据植入前1周内CT图像应用计算机治疗计划系统制定粒子植入计划，按计划在CT或B超引导下穿刺植入碘125粒子，术后4～6个月内复查CT观察粒子分布及疗效。结果 根据疗效评价标准判定，完全缓解(CR)38.46%(15/39)；部分缓解(PR)48.71%(19/39)；无变化(AC)7.69%(3/39)；恶化(PD)5.12%(2/39)。总有效率(CR+PR)为87.18%(34/39)，未见严重并发症和治疗相关的放射损伤。 结论 碘125粒子永久植入治疗转移淋巴结及淋巴瘤是一种安全、可靠，疗效显著的治疗方法。 [关键词] 碘125粒子； 放疗； 恶性淋巴结肿大； 安全性 [中图分类号] R322.2+5[文献标识码] A[文章编号] 1005-0515（2011）-01-005-01 [Abstract]Objective To introduce the clinical value of the treatment for lymphadenopathy due to m alignant metastatic carcinoma of lymph node or lymphoma using the method of implantation with I125 under the guidance of CT or ultrasonic. Methods According to the systemic implantation plant on the basis of the previous week CT records, 31 patients of m alignant lymph nodes and 8 patients of lymphoma were implanted I125 under the guidance of CT or ultrasonic. All the patients had CT-review four or six month after the surgery to observe I125-distribution and evaluate the effect. ResultAccording to the therapeutic effect and evaluative standard, 38.46%(15?39) of them are completely remission, 48.71%(19/39) of them are partly remission , 7.69%(3/39) of them have no change and 5.12%(2/39) of them get degeneration. The total effect rate (CR+PR) is 87.18% (34/39) and no severe complication and no radiation injury happened during this process. ConclusionThe treatment for m alignant lymphadenovarix using the method of implantation with I125 is safe, reliable and effectively. [Keywords] I125； herapy of radiation； lymphadenopathy； safty 淋巴结转移是影响恶性肿瘤分期、治疗和预后的重要因素，恶性肿瘤经过综合治疗后残留淋巴结或新出现的淋巴结转移，往往治疗比较困难 ；恶性淋巴瘤的治疗离不开放疗和化疗，放疗针对Ⅰ－Ⅱ期，但其晚期所致的淋巴结肿大往往范围广，首选化疗[1]，但化疗无效的病人治疗方法不多。本研究旨在评价碘125粒子植入治疗恶性淋巴结肿大的有效性和临床价值 。 1 资料和方法 1.1 资料 2006年7月～2010年5月收治的淋巴结转移患者31例，男18例，女13例，年龄51～89岁，中位年龄71岁。患者经影像学检查结合经皮穿刺活检病理学检查确诊，其中肺癌转移21例，鼻咽鳞癌放疗后复发转移7例，胃癌术后转移3例；恶性淋巴瘤所致的局部淋巴结肿大8例，男4例，女4例，年龄28～61岁，中位年龄45岁。上述原因所致淋巴结肿大的部位和数目：颈部17例，腋窝6例，锁