Title125I放射性粒子链腔内近距离放疗输尿管癌的初步经验
Other TitlesPreliminary experience of 125I seed strands cavity brachytherapy for ureteral carcinoma
Authors焦德超
韩新巍
王俊杰
张建好
王艳丽
水少锋
任建庄
李宗明
张全会
牛荣仿
Affiliation450052,郑州大学第一附属医院介入科
100191,北京大学第三医院肿瘤放疗科
Keywords125I粒子链
近距离放疗
输尿管癌
125I seed strands
Brachytherapy
Ureteral carcinoma
Issue Date2017
Publisher中华放射医学与防护杂志
Citation中华放射医学与防护杂志. 2017, 37(7), 508-513.
Abstract目的 初步评价放射性125I粒子链腔内近距离放疗输尿管癌的安全性和有效性.方法 10例输尿管癌患者采用C臂CT联合数字血管造影(DSA)引导进行肾造瘘,并在输尿管闭塞/狭窄段置入125I粒子链行腔内近距离放疗.评价技术成功率、并发症、肿瘤局部控制率、输尿管通畅情况和生存时间,比较治疗前后Karnofsky评分、肾积水Girignon分级和疼痛评分,对比术前术后剂量学参数.结果 所有患者均顺利完成肾造瘘及粒子链植入,技术成功率100%,操作时间(12.3 ±3.8)min,无输尿管穿孔、感染、严重出血等情况发生.粒子链近距离放疗后2~3个月,局部病灶评价CR 4例,PR 6例,局部控制率(CR+ PR) 100%.输尿管通畅率50% (5/10).患者术后Karnofsky评分,肾积水Girignon分级,疼痛评分均较术前明显改善(Z=-2.72、-2.88、-2.83,P<0.01).平均随访(14.6±6.5)(5 ~25)个月,3例随访期间病情进展,7例病情稳定;9例患者存活,1例因多器官衰竭死亡.术前术后D90%、mPD、V200%、V150%、V200%、CI、EI、HI比较,差异均无统计学意义(P>0.05).结论 肾造瘘联合放射性粒子链腔内近距治疗输尿管癌安全有效,无严重并发症,是无法接受外科根治术患者有效替代方案.
Objective To evaluate the safety and efficacy of 125I seed strands cavity brachytherapy for ureteral carcinoma.Methods To tally 10 patients with ureteral carcinoma underwent Carm CT and DSA guided percutaneous nephrostomy with 125I seed strands cavity brachytherapy.The technical success rate,complications,tumor local control rate,ureteral patency andsurvival time,and compared the Karnofsky scores,Girignon grade,pain score before and after treatment were evaluated.The dose related parameters were compared between pre-and post-treatment.Results 125I seed strands implantation was successfully completed in all patients with technical success rate of 100%.The mean procedure time was (12.3 ±3.8) min.No severe complications such as ureteral perforation,infection,severe bleeding occurred.Local tumor response was CR in 4 cases and PR in 6 cases,showing local control efficiency (CR + PR) 100% after 2-3 months.Ureteral patency rate was 50% (5/10).Postprocedure Karnofsky scores,Girignon grades,and pain scores were significantly improved (Z =-2.72,-2.88,-2.83,P<0.01).The average follow-up time was (14.6 ±6.5) months (5-25 months),tumor progression was observed in 3 cases,stable disease in 7 cases.Nine cases were alive and one died due to multiple organ failure.The differences of D90%,mPD,V100%,V150%,V200%,CI,EI,HI between the preand post-treatment were not statistically significant (P > 0.05).Conclusions 125I seed strands cavity brachytherapy for ureteral carcinoma is an effective and safe procedure without serious complications,and an effective alternative treatment for patients who are unable to undergoor refuse surgery.
URIhttp://hdl.handle.net/20.500.11897/476830
ISSN0254-5098
DOI10.3760/cma.j.issn.0254-5098.2017.07.007
Indexed中国科学引文数据库(CSCD)
Appears in Collections:第三医院

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