131I间碘苄胍治疗94例恶性嗜铬细胞瘤转移灶25年随访疗效评价.docVIP

131I-间碘苄胍治疗94例恶性嗜铬细胞瘤转移灶25年随访的疗效评价 　　[摘要] 目的：观察并总结131I-间碘苄胍（131I-MIBG）治疗恶性嗜铬细胞瘤转移灶的临床疗效。方法：我院1986年1月~2010年1月共收治94例恶性嗜铬细胞瘤转移的患者。按转移瘤大小将其分为三组，三组患者均每隔1~2个月静滴131I-MIBG 80~100 mCi，如果肿瘤组织接受辐照剂量达1 000 cGy/g以上，则每隔3~6个月治疗1次，每次80~100 mCi。结果：大部分患者症状消失，治疗总有效率达73.4%。131I-MIBG对于中小体积的肿瘤的治疗效果较好，与大体积肿瘤疗效比较，差异有统计学意义（χ2=143.19，P0.05）。每克肿瘤组织接受辐照的剂量与其原始大小有密切关系。每克肿瘤组织接收剂量达1 500~2 000 cGy时，肿瘤可消失或明显缩小。结论：131I-MIBG对恶性嗜铬细胞瘤转移灶具有较好的疗效且副反应较小，不能行手术切除者可首选此方法治疗。 　　[关键词] 恶性嗜铬细胞瘤；131I-间碘苄胍；副作用；辐照剂量 　　[中图分类号] R817.8 [文献标识码] A [文章编号] 1673-7210（2011）11（b）-029-03 　　 　　Efficacy evaluation of 25-year follow-up in 94 cases of m alignant pheochromocytoma with metastases treated by 131I- meta-iodo benzyl guanidine 　　LUO Qiong, LUO Quanyong, ZHU Ruisen, YUAN Zhibin, DING Ying 　　Department of Nuclear Medicine, Shanghai Jiaotong University Affiliated the Sixth People′s Hospital, Shanghai 200233, China 　　[Abstract] Objective: To observe and summarize the therapeutic effects of 131I-MIBG in treatment of m alignant pheochromocytoma with metastases. Methods: 94 patients of m alignant pheochromocytoma with metastases who were treated from January 1986 to January 2010 in our hospital were classified into 3 groups according to their tumor size. Intravenous infusion of 131I-MIBG 80-100 mCi was given every 1-2 months, or every 3-6 months if the absorption dose per gram of tumor was above 1 000 cGy. Results: Clinical symptoms disappeared in most patients after treatment, and the total effective rate was 73.4%. The effects in the small and medium volume groups were better than those in the large volume group (χ2=143.19, P0.05). The absorption dose of tumor was closely related to its volume. When the absorption dose of tumor attained 1 500-2 000 cGy/g, the tumor was smaller or disappear obviously. Conclusion: 131I-MIBG has certain therapeutic effectiveness and low side effects in treatment of m alignant pheochromocytoma with metastases. Thus, treatment with 131I-MIBG should be the first selection for masses unabl