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目的探讨CT引导下~(125)I粒子植入治疗Ⅲ~Ⅳ期胃癌淋巴结转移的安全性及疗效。方法回顾性分析2005年1月至2016年5月晚期胃癌淋巴结转移15例患者的治疗情况,其中淋巴结直径≤5 cm 6例、>5 cm 9例,CT引导下植入~(125)I粒子,活度0.3~0.7 mCi,术后验证D90、V100、V150,且与术前进行对比,观察病灶大小及并发症。结果15例患者均手术顺利,随访时间6~18个月,6个月局部控制率为93.3%、有效率为73.3%,6、12个月生存率分别为100%、31%。D90、V100、V150术前与术后各指标比较差异均无统计学意义(P值分别为0.100、0.628、0.971)。未见大出血、胃穿孔、肠道感染、骨髓抑制、皮肤黏膜反应等并发症。结论CT引导下~(125)I粒子植入治疗Ⅲ~Ⅳ期胃癌淋巴结转移近期疗效较好,是一种安全可行的方法。
Objective To investigate the safety and efficacy of ~ (125) I particle implantation guided by CT guided lymph node metastasis in stage Ⅲ ~ Ⅳ gastric cancer. Methods The clinical data of 15 patients with advanced gastric cancer with lymph node metastasis from January 2005 to May 2016 were retrospectively analyzed. Among them, 6 cases were ≤5 cm in diameter, 9 were> 5 cm in diameter, and 125 I seeds were implanted under CT guidance , Activity 0.3 ~ 0.7 mCi, postoperative D90, V100, V150, and compared with the preoperative observation of the size of the lesion and complications. Results All the 15 patients were operated successfully. The follow-up time ranged from 6 to 18 months. The local control rate was 93.3% and the effective rate was 73.3% at 6 months. The survival rates at 6 and 12 months were 100% and 31%, respectively. D90, V100, V150 between the preoperative and postoperative indicators were no significant difference (P values were 0.100,0.628,0.971). No major bleeding, gastric perforation, intestinal infection, bone marrow suppression, skin and mucous membrane reactions and other complications. CONCLUSION: CT-guided 125 I seed implantation is a safe and feasible method for the treatment of stage III-IV gastric cancer with lymph node metastases.