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放射性125I密封籽源瘤内植入治疗局部复发胸腺瘤的近期临床疗效
吉永烁1,张宇2,朱绫琳1,朱君秋1,朱衍菲1,赵洪1*
0
(1. 复旦大学附属华东医院肿瘤科, 上海 200040;
2. 上海曜欣门诊部, 上海 200023
*通信作者)
摘要:
目的 探讨放射性125I密封籽源瘤内植入治疗局部复发胸腺瘤的近期临床疗效与安全性。方法 2015年1月至2018年12月,42例局部复发胸腺瘤患者在复旦大学附属华东医院接受放射性125I密封籽源瘤内植入治疗,观察手术并发症及术后放射损伤情况。通过CT扫描评估治疗前后肿瘤大小的变化,计算肿瘤体积和客观有效率;采用疼痛数字评价量表(NRS)评估局部疼痛症状,计算疼痛缓解率。结果 42例患者均顺利完成手术。术后2例患者发生低热、1例发生气胸,2例发生局部皮肤1级放射性损伤,无其他不良反应。治疗前肿瘤体积为(37.2±8.4)cm3,治疗后2、4、6个月肿瘤体积分别缩小至(18.6±4.2)、(15.3±4.0)、(14.9±3.7)cm3;治疗后6个月客观缓解率为95.2%(40/42)。24例患者治疗前有局部疼痛症状,中位NRS评分为4(1~9)分,治疗后2、4、6个月时中位NRS评分分别下降至1(0~6)、1(0~5)、1(0~5)分;治疗后6个月疼痛缓解率为87.5%(21/24)。结论 放射性125I密封籽源植入治疗局部复发胸腺瘤近期临床疗效好,并发症少,安全可靠。
关键词:  胸腺肿瘤  125I密封籽源  近距离放射治疗  局部复发
DOI:10.16781/j.0258-879x.2020.07.0803
投稿时间:2020-04-20修订日期:2020-05-09
基金项目:
Short-term clinical efficacy of radioactive 125I sealed seed implantation in the treatment of local recurrence of thymoma
JI Yong-shuo1,ZHANG Yu2,ZHU Ling-lin1,ZHU Jun-qiu1,ZHU Yan-fei1,ZHAO Hong1*
(1. Department of Oncology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China;
2. Yaoxin Outpatient Department, Shanghai 200023, China
*Corresponding author)
Abstract:
Objective To assess the short-term clinical efficacy and safety of radioactive 125I sealed seed implantation in the treatment of local recurrence of thymoma. Methods A total of 42 patients with local recurrence of thymoma received 125I sealed seeds brachytherapy in Huadong Hospital affiliated to Fudan University during Jan. 2015 and Dec. 2018. Surgical complications and postoperative radiation injuries were observed. Computed tomography (CT) scan was used to evaluate the change of tumor size, and then to calculate the tumor volume and the objective response rate before and after treatment. The local pain was evaluated by numerical rating scale (NRS) and the pain remission rate was calculated. Results All the 42 patients successfully received the operation. Low fever occurred in two patients, pneumothorax occurred in one patient, and local skin grade Ⅰ radiodermatitis occurred in two patients after implantation. No other adverse events occurred. The tumor volume was (37.2±8.4) cm3 before treatment, and it was (18.6±4.2), (15.3±4.0) and (14.9±3.7) cm3 at 2, 4 and 6 months after treatment, respectively. The objective response rate was 95.2% (40/42) at 6 months after treatment. Twenty-four patients had local pain before treatment, the median NRS score was 4 (1-9), and the NRS score decreased to 1 (0-6), 1 (0-5) and 1 (0-5) at 2, 4 and 6 months after treatment, respectively. The pain remission rate was 87.5% (21/24) at 6 months after treatment. Conclusion Radioactive 125I sealed seed implantation is a safe and effective method in the treatment of local recurrence of thymoma, with a good short-term clinical efficacy and fewer complications.
Key words:  thymus neoplasms  125I sealed seed  brachytherapy  local recurrence