中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2015年
2期
87-90
,共4页
王营%郭志%张炜浩%倪虹
王營%郭誌%張煒浩%倪虹
왕영%곽지%장위호%예홍
复发性卵巢癌%125I粒子%近距离放射治疗%化疗
複髮性卵巢癌%125I粒子%近距離放射治療%化療
복발성란소암%125I입자%근거리방사치료%화료
recurrent ovarian cancer%125I seed%brachytherapy%chemotherapy
目的：探讨CT引导下125I粒子植入联合化疗治疗复发性卵巢癌患者的临床疗效及安全性。方法：回顾性分析采用125I粒子植入联合化疗治疗的21例复发性卵巢癌患者资料。共29处可评价病灶，其中25处适合125I粒子植入治疗。应用治疗计划系统制定125I粒子植入计划，在CT引导下植入粒子。粒子植入术后3 d内行紫杉醇脂质体静脉化疗，次日经肿瘤供血动脉灌注卡铂，每3周重复1次，随访观察治疗效果及并发症。结果：2个疗程化疗结束后125I粒子植入治疗的25处病灶中完全缓解（CR）为16%（4/25）、部分缓解（PR）为56%（14/25）、疾病稳定（SD）为12%（3/25）、疾病进展（PD）为16%（4/25），总有效率（CR+PR）为72%（18/25），疼痛缓解率为82.4%（14/17），KPS评分较治疗前升高（P=0.019）。中位无进展生存时间（PFS）为6.8个月，中位生存时间（OS）为14.2个月，1年生存率为42.9%（9/21），主要为血液学及消化道不良反应，所有患者未发生严重的放射性损伤并发症。结论：125I粒子植入治疗联合化疗能够提高复发性卵巢癌患者的临床缓解率，改善临床症状，并且耐受性良好。
目的：探討CT引導下125I粒子植入聯閤化療治療複髮性卵巢癌患者的臨床療效及安全性。方法：迴顧性分析採用125I粒子植入聯閤化療治療的21例複髮性卵巢癌患者資料。共29處可評價病竈，其中25處適閤125I粒子植入治療。應用治療計劃繫統製定125I粒子植入計劃，在CT引導下植入粒子。粒子植入術後3 d內行紫杉醇脂質體靜脈化療，次日經腫瘤供血動脈灌註卡鉑，每3週重複1次，隨訪觀察治療效果及併髮癥。結果：2箇療程化療結束後125I粒子植入治療的25處病竈中完全緩解（CR）為16%（4/25）、部分緩解（PR）為56%（14/25）、疾病穩定（SD）為12%（3/25）、疾病進展（PD）為16%（4/25），總有效率（CR+PR）為72%（18/25），疼痛緩解率為82.4%（14/17），KPS評分較治療前升高（P=0.019）。中位無進展生存時間（PFS）為6.8箇月，中位生存時間（OS）為14.2箇月，1年生存率為42.9%（9/21），主要為血液學及消化道不良反應，所有患者未髮生嚴重的放射性損傷併髮癥。結論：125I粒子植入治療聯閤化療能夠提高複髮性卵巢癌患者的臨床緩解率，改善臨床癥狀，併且耐受性良好。
목적：탐토CT인도하125I입자식입연합화료치료복발성란소암환자적림상료효급안전성。방법：회고성분석채용125I입자식입연합화료치료적21례복발성란소암환자자료。공29처가평개병조，기중25처괄합125I입자식입치료。응용치료계화계통제정125I입자식입계화，재CT인도하식입입자。입자식입술후3 d내행자삼순지질체정맥화료，차일경종류공혈동맥관주잡박，매3주중복1차，수방관찰치료효과급병발증。결과：2개료정화료결속후125I입자식입치료적25처병조중완전완해（CR）위16%（4/25）、부분완해（PR）위56%（14/25）、질병은정（SD）위12%（3/25）、질병진전（PD）위16%（4/25），총유효솔（CR+PR）위72%（18/25），동통완해솔위82.4%（14/17），KPS평분교치료전승고（P=0.019）。중위무진전생존시간（PFS）위6.8개월，중위생존시간（OS）위14.2개월，1년생존솔위42.9%（9/21），주요위혈액학급소화도불량반응，소유환자미발생엄중적방사성손상병발증。결론：125I입자식입치료연합화료능구제고복발성란소암환자적림상완해솔，개선림상증상，병차내수성량호。
Objective:To evaluate the safety and efficacy of a palliative regimen of computed tomography (CT)-guided 125I seed im-plantation combined with chemotherapy for recurrent ovarian cancer. Methods:A total of 21 patients with recurrent ovarian cancer, who received 125I seed implantation and chemotherapy, were retrospectively analyzed. Out of the 29 lesions detected, 25 lesions were suitable for 125I seed implantation. Treatment planning system (TPS) was implemented preoperatively to determine the number and dis-tribution of 125I seeds. Under CT guidance, 125I seeds were implanted into the recurrent lesions using the TPS. Within 3 d of 125I seed im-plantation, liposomal paclitaxel was administered by intravenous infusion on day 1 and carboplatin by infusion via the feeding artery of tumor on day 2. Chemotherapy was repeated on a 21-day schedule. Efficacy and complications were evaluated during follow-up. Re-sults:After two cycles of chemotherapy, out of the 25 recurrent lesions that underwent 125I seed implantation, four lesions showed com-plete remission, 14 with partial remission, three with stable disease, and four with progression of disease. The objective response rate was 72%, and the pain relief rate was 82.4%. Karnofsky's performance status scores increased dramatically (P=0.019). The median pro-gression-free survival time was 6.8 months, median overall survival time was 14.2 months, and the 1-year survival rate was 42.9%. He-matologic toxicity and gastrointestinal reactions were the primary adverse conditions. No severe radiation complications and treat-ment-related deaths were observed in all patients. Conclusion:CT-guided 125I seed implantation combined with chemotherapy is active and well-tolerated in patients with recurrent ovarian cancer. This combined treatment cannot only significantly enhance the objective re-sponse rate, but also leads to remarkable improvement in cancer-related symptoms.
