放射性粒子125Ⅰ联合高强度聚焦超声治疗肝癌的临床疗效

目的 探讨应用放射性粒子125Ⅰ联合高强度聚焦超声治疗肝癌的临床疗效及可行性.方法 四川大学华西医院自2006年6月～2007年4月采用放射性粒子125Ⅰ联合高强度聚焦超声治疗肝癌10例,其中5例为原发性肝癌患者,5例为肝癌术后复发患者.在治疗计划指导下,利用放射性粒子125Ⅰ联合高强度聚焦超声进行治疗.结果 10例患者手术均顺利完成.所有患者术后未发生出血、感染等严重并发症,部分患者肝功能出现损害,经常规保肝治疗后恢复.术后经腹部摄片证实放射性粒子的位置无变化,于术后1、3、6月作CT复查肿瘤体积变化,提示肿瘤不同程度缩小.术后1月存活8例,术后3月存活7例,术后6月存活5例,术后1年存活2例.随访3～18个月,其中最短存活1个月,最长存活22个月,有2例患者现仍然存活.其余患者死于术后全身广泛转移.结论 放射性125l粒子和高强度聚焦超声联合应用具有安全、微创及并发症发生率低的特点,是综合治疗肝癌的有效手段之一.

Clinical feasibility of 125Ⅰ combined、with high intensity focused ultrasound(HIFU)therapy for hepatocellular carcinoma

Objective To evaluate efficacy and clinical feasibility of 125Ⅰ combined with high intensity focused ultrasound(HIFU)therapy for hepatocellular carcinoma.Methods.The study included 10 cases of hepatocellular carcinoma(primary hepatic carcinoma,5 cases.Tumor recurrence of hepatocelluhr carcinoma after hepatecomy,5 cases).All the cases were treated with 125I combined with HIFU.Resultsl The operationWas successfully completed in all the cases.No severe post-operative complication occurred.CT acall found no displacement of 125Ⅰ seeds.CT 8can showed that reduced size of tmnor changed in different degree.The l month,3 month,6 month and l year survival cases were 8,7,5 and 2.During 3 to 18 months follow up,2 cases died within 1 month.Two cases survived more than 22 months.Conclusion Using 125Ⅰ combined with HIFU is safe,minimally invasive and effective for treatment of hepatocellular careinom.