CAJ | 학술논문

目的探讨经皮肝动脉碘油化疗栓塞（TACE）联合B超引导下125I放射性粒子植入治疗巨块型肝癌的临床疗效及安全性。方法选择2011年10月至2012年8月收治的巨块型肝癌患者共35例，17例经过TACE治疗后2~4周行CT扫描，采用计算机三维治疗计划系统（TPS）计算所需粒子数目及预计放射剂量，B超引导下行125I放射性粒子植入，术后复查CT，计算并调整放射剂量。粒子植入术后定期复查CT及AFP等指标。结果17例患者均顺利完成TACE联合B超引导下125I放射性粒子植入治疗。全部病例术后无局部感染、大出血等并发症，毒性不良反应少。术后4 d复查，血常规、肝肾功能正常。3个月后复查CT，肝内病灶完全缓解（CR）0例，部分缓解（PR）13例，稳定（SD）4例；6个月复查，肝内病灶CR 3例，PR 10例，SD 2例，疾病进展（PD）2例，其中PR、CR患者中有3例出现肺转移。随访1年，1年生存率58.82%。结论 TACE联合B超引导下125I放射性粒子植入治疗巨块型肝癌可以提高局部控制率，临床疗效确切，并发症少。
목적탐토경피간동맥전유화료전새（TACE）연합B초인도하125I방사성입자식입치료거괴형간암적림상료효급안전성。방법선택2011년10월지2012년8월수치적거괴형간암환자공35례，17례경과TACE치료후2~4주행CT소묘，채용계산궤삼유치료계화계통（TPS）계산소수입자수목급예계방사제량，B초인도하행125I방사성입자식입，술후복사CT，계산병조정방사제량。입자식입술후정기복사CT급AFP등지표。결과17례환자균순리완성TACE연합B초인도하125I방사성입자식입치료。전부병례술후무국부감염、대출혈등병발증，독성불량반응소。술후4 d복사，혈상규、간신공능정상。3개월후복사CT，간내병조완전완해（CR）0례，부분완해（PR）13례，은정（SD）4례；6개월복사，간내병조CR 3례，PR 10례，SD 2례，질병진전（PD）2례，기중PR、CR환자중유3례출현폐전이。수방1년，1년생존솔58.82%。결론 TACE연합B초인도하125I방사성입자식입치료거괴형간암가이제고국부공제솔，림상료효학절，병발증소。
Objective To investigate the clinical efficacy and security of B ultrasound guided 125I seeds implantation combined with transcatheter hepatic arterial oily chemoembolization(TACE) for huge-type hepatoma. Methods Two to four weeks after TACE treatment, CT scanning was performed for 17 patients, and the number of seeds needed and the expected radiation dose were computed by treatment planning system(TPS). After operating the B ultrasound guided 125I seeds implantation, the CT reexamination and computed radiation dose by TPS was performed again. CT and AFP regular reexamination were performed after the seed implantation. Results After 3 months, CT showed that complete remission (CR) was observed in no patients, partial remission (PR) in 13 patients and stable disease (SD) in 4 patients. After 6 months, CT showed that CR was observed in 3 patients, PR in 10 patients, SD in 2 patients and progress disease (PD) in 2 patients. Lung metastasis occurred in 3 patients among the PR and CR cases. During a one year follow-up, the one-year survival rate was 58.82%. Conclusion B ultrasound guided 125I seeds implantation combined with TACE for huge-type hepatoma can markedly improve the local control rate with good clinical effect and lower complications.