放射性粒子碘125插置组织间治疗晚期肿瘤的临床疗效

目的:探讨放射性粒子碘125插置组织间治疗晚期肿瘤的疗效。方法:选择2008年7月至2011年4月经我院收治的晚期肿瘤患者95例,全部患者均经放射性粒子碘125插置组织间治疗,观察患者疗效、不良反应、免疫指标及肿瘤标志物水平,并随访6-24月观察患者生存率。结果:95例患者临床有效率为83.15%,其中CR 23例(24.21%),PR 56例(58.94%),PD 9例(9.47%),SD 7例(7.37%)。在碘125插置过程中出现7例气胸,术后出现2例咳血、1例排便困难和3例出现发热并伴穿刺处疼痛。全部患者治疗前后IgG、IgA和IgM水平无显著性变化(P0.05),而治疗后4周各病种晚期肿瘤患者相应肿瘤标志物水平显著低于治疗前,差异有统计学意义(P0.05)。53例肺癌患者中,半数生存期为20个月,术后1、2年生存率分别为86.79%和41.51%;而同期行姑息手术且未接受放射性粒子碘125插置组织间治疗的40例肺癌患者,半数生存期仅为12个月,术后1、2年生存率分别为57.50%和22.50%,两组比较,差异有统计学意义(P0.05)。结论:放射性粒子碘125插置组织间治疗晚期肿瘤具有适应症广、安全性高、临床效果好和不良反应少等优点,还可提高晚期肿瘤患者的生存期。

Effects of Radioactive 125-Iodine Seed Implantation for the Treatment of Advanced Tumor

Objective： To discuss the effects of radioactive 125-Iodine seed implantation for advanced tumor. Methods： A total of 95 advanced tumor patients were retrospectively analyzed from 2008 July to 2011 April. These patients were treated by radioactive 125-Iodine seed implantation. Curative effect, side-effect, immune globulin and tumor marker levels were observed.And survival of the patients were followed up for 6 to 24 months observation. Results： The total effect rate was 83.15%, including CR（23 cases, 24.21%）, PR （56 cases, 58.94%）, PD （9 cases, 9.47%）, SD （7 cases, 7.37%）. Of the 95 patients, there were 7 cases of pneumothorax, 2 cases of hemoptysis, 1 case of defecation difficulty, and 3 cases with fever and with piercing pain. Comparison before and after treatment, there was no significant change of IgG, IgA and IgM level （P〉0.05）; but 4 weeks after treatment, the tumor marker levels were all significantly lowered （P〈0.05）. The median survival time, postoperative 1, 2 year survival rates （20 months, 86.79% and 41.51% respectively） of lung cancer obsebcation group were significantly higher than lung cancer control group （12 months, 57.50% and 22.50% respectively）, with significant difference （P〈0.05）. Conclusion： Radioactive 125-Iodine seed implantation has wide indications, high security, good clinical effect and less adverse reaction, and also can improve the survival period of patients with advanced tumors.