射频消融联合放射性~(125)I粒子植入治疗胃癌肝转移的疗效观察
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摘要
目的探讨射频消融联合放射性~(125)I粒子植入治疗胃癌肝转移的安全性和近期疗效。方法收集2016年12月~2017年12月于我院行射频消融联合放射性~(125)I粒子植入治疗的17例胃癌肝转移患者的临床资料进行回顾性研究。经治疗计划系统制定计划,超声引导下按计划植入0.7 m Ci粒子,处方剂量为120~140Gy,术后做等剂量曲线进行验证评估。术后2个月复查肿瘤局部控制情况评价疗效。结果所有患者经过治疗,2个月后完全缓解+部分缓解(CR+PR)15例(88.2%)。治疗后局部病灶均无进展,无严重并发症。结论射频消融联合放射性~(125)I粒子植入治疗胃癌肝转移可以取得良好的肿瘤局部控制率,具有并发症少、简便安全等优点。是一种相对安全、有效的胃癌肝转移治疗方法。
Objective To explore the safety and short-term effect of radiofrequency ablation combined with radioactive ~(125)I particle implantation in the treatment of liver metastasis of gastric cancer. Methods The clinical data of 17 patients with liver metastasis from gastric cancer,who were admitted to authors ' hospital during the period from Dec 2016 to Dec 2017 to receive radiofrequency ablation combined with ~(125)I seed permanent implantation therapy,were retrospectively analyzed.According to the plan of treatment planning system,0.7 m Ci particles were implanted under the guidance of ultrasound, and the prescription dose was 120~140 Gy.After that, the isodose curve was used for verification and evaluation. Evaluation of local control of tumor after 2 months after operation.Results After two months of treatment,15 cases(88.2%) were completely remission+partial remission(CR+PR).There were no progress in local lesions and no serious complications after treatment.Conclusion Radiofrequency ablation combined with radioactive ~(125)I particle implantation can achieve good local control rate for liver metastases from gastric cancer.It has the advantages of less complications,simple and safe.It is a relatively safe and effective method for the treatment of liver metastasis of gastric cancer.
Objective To explore the safety and short-term effect of radiofrequency ablation combined with radioactive ~(125)I particle implantation in the treatment of liver metastasis of gastric cancer. Methods The clinical data of 17 patients with liver metastasis from gastric cancer,who were admitted to authors ' hospital during the period from Dec 2016 to Dec 2017 to receive radiofrequency ablation combined with ~(125)I seed permanent implantation therapy,were retrospectively analyzed.According to the plan of treatment planning system,0.7 m Ci particles were implanted under the guidance of ultrasound, and the prescription dose was 120~140 Gy.After that, the isodose curve was used for verification and evaluation. Evaluation of local control of tumor after 2 months after operation.Results After two months of treatment,15 cases(88.2%) were completely remission+partial remission(CR+PR).There were no progress in local lesions and no serious complications after treatment.Conclusion Radiofrequency ablation combined with radioactive ~(125)I particle implantation can achieve good local control rate for liver metastases from gastric cancer.It has the advantages of less complications,simple and safe.It is a relatively safe and effective method for the treatment of liver metastasis of gastric cancer.
引文
[1]Moon YH,Jeung HC,Rha SY,et al.Changing patterns of prognosticators during 15-year follow-up of advanced gastric cancer after radial gastrectomy and adjuvant chemotherapy:a 15-year follow-up study at a single Korean institute[J].Ann Surg Oncol 2007,14(10):2730–2737.
[2]Ambiru S,Miyazaki M,Ito H,et al:Benefits and limits of hepatic resection for gastric metastases[J].Am J Surg2001,181(3):279–83.
[3]Llovet Jm,Di Bisceglie AM,Bruix J,et a1.Design and endpoints of clinical trials in hepatocellular carcinoma[J].J Natl Cancer Inst,2008,100:698-711.
[4]Jun-Eul Hwang,Seung-Hun Kim,Joon Jin,et al.Combination of percutaneous radiofrequency ablation and systemic chemotherapy are effective treatment modalities for metachronous liver metastases from gastric cancer[J].Clin Exp Metastasis,2014,31:25–32.
[5]Wu AW,Yuan P,Li ZY,et al.Capecitabine plus paclitaxel induction treatment in gastric cancer patients with liver metastasis:a prospective,uncontrolled,open-label PhaseⅡclinical study[J].Future Oncol,2016,12(18):2107-2116.
[6]Toshiki Shinohara,Yoshiaki Maeda,Tomonori Hamada,et al.Survival Benefit of Surgical Treatment for Liver Metastases from Gastric Cancer[J].J Gastrointest Surg,2015,19:1043–1051.
[7]Eiji Oki,Shoji Tokunaga,Yasunori Emi,et al.Surgical treatment of liver metastasis of gastric cancer:a retrospective multicenter cohort study(KSCC1302)[J].Gastric Cancer,2016,19(3):968-976
[8]刘岩,刘瑞宝,王平,等.经导管植入1 2 5 I放射性粒子治疗肝癌伴门静脉癌栓19例[J].介入放射学杂志,2015,23(1):35-37.
[9]郑家平,邵国良,罗君,等.CT引导下I 125粒子组织间植入治疗难治性肝癌[J].介入放射学杂志,2015,24(3):260-264.
[10]Peng Sheng,Yang Qiu-Xia,Zhang Tao,et al.LobaplatinTACE combined with radioactive 125I seed implantation for treatment of primary hepatocellular carcinoma[J].Asian Pac J Cancer Prev,2014,15(13):5155-5160.
[11]吴发宗,纪建松,应希慧,等.射频消融联合放射性125I粒子植入治疗多结节型原发性肝癌疗效分析[J].中华医学杂志,2016,96(9):693-696.
[2]Ambiru S,Miyazaki M,Ito H,et al:Benefits and limits of hepatic resection for gastric metastases[J].Am J Surg2001,181(3):279–83.
[3]Llovet Jm,Di Bisceglie AM,Bruix J,et a1.Design and endpoints of clinical trials in hepatocellular carcinoma[J].J Natl Cancer Inst,2008,100:698-711.
[4]Jun-Eul Hwang,Seung-Hun Kim,Joon Jin,et al.Combination of percutaneous radiofrequency ablation and systemic chemotherapy are effective treatment modalities for metachronous liver metastases from gastric cancer[J].Clin Exp Metastasis,2014,31:25–32.
[5]Wu AW,Yuan P,Li ZY,et al.Capecitabine plus paclitaxel induction treatment in gastric cancer patients with liver metastasis:a prospective,uncontrolled,open-label PhaseⅡclinical study[J].Future Oncol,2016,12(18):2107-2116.
[6]Toshiki Shinohara,Yoshiaki Maeda,Tomonori Hamada,et al.Survival Benefit of Surgical Treatment for Liver Metastases from Gastric Cancer[J].J Gastrointest Surg,2015,19:1043–1051.
[7]Eiji Oki,Shoji Tokunaga,Yasunori Emi,et al.Surgical treatment of liver metastasis of gastric cancer:a retrospective multicenter cohort study(KSCC1302)[J].Gastric Cancer,2016,19(3):968-976
[8]刘岩,刘瑞宝,王平,等.经导管植入1 2 5 I放射性粒子治疗肝癌伴门静脉癌栓19例[J].介入放射学杂志,2015,23(1):35-37.
[9]郑家平,邵国良,罗君,等.CT引导下I 125粒子组织间植入治疗难治性肝癌[J].介入放射学杂志,2015,24(3):260-264.
[10]Peng Sheng,Yang Qiu-Xia,Zhang Tao,et al.LobaplatinTACE combined with radioactive 125I seed implantation for treatment of primary hepatocellular carcinoma[J].Asian Pac J Cancer Prev,2014,15(13):5155-5160.
[11]吴发宗,纪建松,应希慧,等.射频消融联合放射性125I粒子植入治疗多结节型原发性肝癌疗效分析[J].中华医学杂志,2016,96(9):693-696.