CAJ | 학술논문

目的探讨125I粒子总活度相同时,不同分布的组织间植入对荷人胃癌裸鼠移植瘤疗效的影响.方法建立人胃低分化腺癌BGC-823细胞裸鼠皮下移植瘤模型32只,按随机数字表法分为实验组和对照组.实验组植入总活度33.30 MBq125I粒子,按照植入单枚活度及分布不同分为高活度组(33.30 MBq×1枚)、中活度组(16.65 MBq×2枚)、低活度组(11.10 MBq×3枚);对照组植入空源粒子.每组8只裸鼠模型.比较实验和对照组及125I粒子不同分布状态下对移植瘤体积的抑制率、组织病理学改变、局部皮肤反应、裸鼠体质量和存活率.采用方差分析和秩和检验对数据进行统计学处理.结果各组存活率均为100%.125I粒子植入第30天裸鼠体质量各组比较,差异无统计学意义[高、中、低活度及对照组分别为(26.44±1.07)、(26.58±0.51)、(27.15±1.37)和(26.92±0.60)g,F=2.23,P>0.05].第30天各实验组125I粒子对肿瘤体积抑制率分别为92.47%,97.15%和89.01%;平均体积各实验组[高、中、低活度组分别为(138.85±16.45)、(52.52±30.54)、(202.72±126.97)mm3]与对照组[(1843.99±447.63)mm3]比较,差异均有统计学意义(t值分别为3.092,3.376,3.269,P均<0.05),中活度组和低活度组组间比较差异有统计学意义(t=2.308,P<0.05),高活度组分别和中活度组、低活度组组间比较差异均无统计学意义(t值分别为1.300,1.007,P均>0.05).高活度组与中活度组组织病理学分级按直肠癌消退分级标准(RCRG)均为RCRG 1级;低活度组3只为RCRG 3级,4只为RCRG 2级,1只为RCRG 1级.中、低活度组均未出现放射性损伤,高活度组中4只裸鼠于125I粒子植入后9～12 d出现放射治疗肿瘤学组织(RTOG)1～2级放射性损伤.结论 125I粒子植入治疗中单源活度的选择和分布方式可直接影响疗效和放射性损伤的程度.
목적 탐토125I입자총활도상동시,불동분포적조직간식입대하인위암라서이식류료효적영향.방법 건립인위저분화선암BGC-823세포라서피하이식류모형32지,안수궤수자표법분위실험조화대조조.실험조식입총활도33.30 MBq125I입자,안조식입단매활도급분포불동분위고활도조(33.30 MBq×1매)、중활도조(16.65 MBq×2매)、저활도조(11.10 MBq×3매);대조조식입공원입자.매조8지라서모형.비교실험화대조조급125I입자불동분포상태하대이식류체적적억제솔、조직병이학개변、국부피부반응、라서체질량화존활솔.채용방차분석화질화검험대수거진행통계학처리.결과 각조존활솔균위100%.125I입자식입제30천라서체질량각조비교,차이무통계학의의[고、중、저활도급대조조분별위(26.44±1.07)、(26.58±0.51)、(27.15±1.37)화(26.92±0.60)g,F=2.23,P>0.05].제30천각실험조125I입자대종류체적억제솔분별위92.47%,97.15%화89.01%;평균체적각실험조[고、중、저활도조분별위(138.85±16.45)、(52.52±30.54)、(202.72±126.97)mm3]여대조조[(1843.99±447.63)mm3]비교,차이균유통계학의의(t치분별위3.092,3.376,3.269,P균<0.05),중활도조화저활도조조간비교차이유통계학의의(t=2.308,P<0.05),고활도조분별화중활도조、저활도조조간비교차이균무통계학의의(t치분별위1.300,1.007,P균>0.05).고활도조여중활도조조직병이학분급안직장암소퇴분급표준(RCRG)균위RCRG 1급;저활도조3지위RCRG 3급,4지위RCRG 2급,1지위RCRG 1급.중、저활도조균미출현방사성손상,고활도조중4지라서우125I입자식입후9～12 d출현방사치료종류학조직(RTOG)1～2급방사성손상.결론 125I입자식입치료중단원활도적선택화분포방식가직접영향료효화방사성손상적정도.
Objective 125Ⅰ seeds interstitial brachytherapy has been clinically used for years. However, how the dose distribution affects the therapeutic response remains to be elucidated. The present study was undertaken to investigate the impact of different dose distribution on the effects of 125Ⅰ seeds interstitial brachytherapy. Methods Thirty-two human gastric carcinoma bearing nude mice were randomly divided into three treated groups and one control group with eight mice in each group. 125Ⅰ seeds were implanted in the treated groups with the same total activity (33.30 MBq). Based on the dose distribution and activity of single seed, the treated groups were classified to high activity group (33.30 MBq×1), moderate activity group (16.65 MBq×2) and low activity group (11.10 MBq×3). The control group was implanted radioactivity-free seeds. The evaluation parameters were obtained after 30 d, which included survival rate, body weight, volume inhibitory rate, histological tumor regression and regional skin reaction. Analysis of variance and Kruskal-Wallis H test were used for data statistical analysis. Results All mice survived during the observation period. There was no significant difference of the body weight among the groups after 125Ⅰ seeds implantation (F = 2.23, P > 0.05). The volume inhibitory rates in high, moderate and low activity groups were 92.47%, 97. 15% and 89. 01%, respectively. After treatment the average tumor volume was (138.85±16.45) mm3 in high activity group, (52.52±30.54) mm3 in moderate activity group, (202.72±126.97) mm3 in low activity group and (1843.99±447.63) mm3 in control group. In all treated groups,the average tumor volume was significantly smaller than that in control group (t = 3.092, 3.376, 3.269, all P <0.05). However, among the treated groups, statistically significant difference in average tumor volume was only found between moderate activity group and low activity group (t=2.308, P < 0.05). The pathological complete response rectal cancer regression grade (RCRG) assessment revealed that RCRG 1 was seen in all the tumors in high activity group and moderate activity group, while all tumors showed RCRG 3 response(H = 23.50, P<0.005) in the control group. In low activity group 1/8 tumor was with RCRG 1, 4/8 with RCRG 2 and 3/8 with RCRG 3. Skin radiation injury was found only in 4/8 nude mice in high activity group with radiation therapy ontology group (RTOG) grade 1- 2. Conclusion The activity of single 125Ⅰ seed and the dose distribution may exert critical impact on the therapeutic effects and radiation injury in125Ⅰseeds interstitial brachytherapy.