125I放射性粒子组织间植入治疗复发性宫颈癌

摘要

Objective To investigate the curative effect and the complication of the CT-guided 125I interstitial implants as salvage therapy for recurrent cervical cancer.Methods From June 2009 to December 2010,a total of 16 patients diagnosed with recurrent cervical cancer were treated with 125I interstitial implantation.According to the area of CT amage,the treatment plan was taken by computerized treatment planning system (TPS) and Memorial Sloan-Ketterin nomograph.The matched peripheral dose (MPD) was 110～160 cGy in the target mass.A median of 25 seeds per patient (range 10～70) was implanted.The efficacy was evaluated by CT findings.Results The follow-up ranged from 4 to 32 mouths.7 patients showed complete remission,3 patients showed partial remission,and 6 patients showed progressive disease.The effective rate was 62％ (10/16).The median local control time was 6 mouths,median survival time was 12 mouths.The 0.5-,1-,2 year local control rates and survival rates were 64.1 ％,29.4 ％,14.7 ％ and 70.1％,47.1 ％,29.4 ％ respectively.Complications of radiation injury including intestinal fistula and proctitis did not appear in all patients.Conclusion The CT-guided 125I interstitial implants as salvage therapy for recurrent cervical cancer has a great short-term curative effect and fewer complications.%目的 探讨125I放射性粒子组织间植入治疗复发性宫颈癌的疗效及并发症.方法 16例根据CT显示的病灶范围,应用放射性粒子治疗计划系统或Memorial Sloan-Ketterin列解图法制定粒子植入计划.植入粒子数10～70颗,中位数25颗,匹配周边剂量为110～160cGy.CT复查判断治疗效果.结果 16例均顺利完成手术,随访4～32月,中位随访时5个月,13例病人患者在随访期内死亡,3例患者随访期内仍存活.7例患者肿瘤完全缓解(CR),3例部分缓解(PR),6例局部进展(PD),临床有效率62％(10/16).局部控制率6月、1年、2年为64.1％,29.4％、14.7％,中位局部控制时间6月;6月、1年、2年生存率为70.1％,47.1％,29.4％,中位生存时间12月.所有患者未见放射性损伤并发症.结论 125I放射性粒子植入治疗对于复发性宫颈癌的补救或姑息治疗,是一种可行、有效、安全的治疗方法.