王 营, 郭 志, 张炜浩, 倪 虹. CT引导下125I 粒子植入联合化疗治疗复发性卵巢癌[J]. 中国肿瘤临床, 2015, 42(2): 87-90. DOI: 10.3969/j.issn.1000-8179.20140396
引用本文: 王 营, 郭 志, 张炜浩, 倪 虹. CT引导下125I 粒子植入联合化疗治疗复发性卵巢癌[J]. 中国肿瘤临床, 2015, 42(2): 87-90. DOI: 10.3969/j.issn.1000-8179.20140396
Ying WANG, Zhi GUO, Weihao ZHANG, Hong NI. Computed tomography-guided 125I seed implantation combinedwith chemotherapy in treating recurrent ovarian cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(2): 87-90. DOI: 10.3969/j.issn.1000-8179.20140396
Citation: Ying WANG, Zhi GUO, Weihao ZHANG, Hong NI. Computed tomography-guided 125I seed implantation combinedwith chemotherapy in treating recurrent ovarian cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2015, 42(2): 87-90. DOI: 10.3969/j.issn.1000-8179.20140396

CT引导下125I 粒子植入联合化疗治疗复发性卵巢癌

Computed tomography-guided 125I seed implantation combinedwith chemotherapy in treating recurrent ovarian cancer

  • 摘要: 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。

     

    Abstract: 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 of21patients with recurrent ovarian cancer, who received 125I seed implantation and chemotherapy, were retrospectively analyzed. Out of the 29lesions detected, 25lesions 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 the25recurrent lesions that underwent 125I seed implantation, four lesions showed com-plete remission, 14with partial remission, three with stable disease, and four with progression of disease. The objective response rate was 72%, and the pain relief rate was82.4%. 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 the1-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.

     

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