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目的 探讨12 5I组织间放射治疗大肝癌和巨大肝癌的疗效。方法 选择 1999年 8月至 2 0 0 4年 3月云南省第二人民医院大肝癌和巨大肝癌病人 6 0例 ,行手术治疗 (部分巨大肝癌姑息手术 )、术中永久植入12 5I粒子行组织间内放射治疗 ;观察治疗前后病人血象、免疫指标、临床症状、脏器功能 (ALT、AST)、肿瘤标记物(AFP)、肿瘤影像学 (CT)等的变化 ;并观察 3年生存率。结果 术前、术后 1周及 3个月内血象虽有显著差异 ,但均在正常范围 ,免疫指标前后变化无统计学意义 ;治疗后病人临床症状缓解率为 95 % (5 1/ 5 4 ) ;ALT、AST由异常降至正常水平者占 80 % (32 / 4 0 )、70 % (30 / 4 3) ;AFP降低超过原数值 5 0 %者占 75 % (30 / 4 0 ) ;直径在 5～ 10cm的5 5个瘤体的治疗有效率为 76 % (4 2 / 5 5 ) ,直径 >10cm的 32个瘤体治疗有效率为 6 9% (2 2 / 32 )。结论 12 5I组织间放射治疗大肝癌方法简单、疗效显著、使用安全。
Objective To investigate the efficacy of 125I interstitial radiotherapy in treating large hepatocellular carcinoma and giant hepatocellular carcinoma. Methods Sixty patients with major hepatocellular carcinoma and giant hepatocellular carcinoma at the Second People’s Hospital of Yunnan Province from August 1999 to March 2004 were enrolled in this study. Surgical treatment (partial gigantic hepatocellular carcinoma) was performed. Perioperative implantation of 125I particles The changes of blood, immune, clinical symptoms, organ function (ALT, AST), tumor markers (AFP) and tumor imaging (CT) were observed before and after treatment. The 3-year survival rate . Results Although there were significant differences in blood before surgery, within 1 week and 3 months after operation, all the blood samples were within the normal range and there was no significant difference before and after the immune index. After treatment, the clinical symptom response rate was 95% (51/54 ); ALT, AST decreased from abnormal to normal levels accounted for 80% (32/40), 70% (30/43); AFP decreased more than the original value of 50% accounted for 75% (30/40); The effective rate of treatment for 5 5 tumors with a diameter of 5 to 10 cm was 76% (4 2/5 5), and that of 32 tumors with a diameter> 10 cm was 6 9% (2 2/32). Conclusion 12 5I interstitial radiotherapy of large liver cancer is simple, effective, safe to use.