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組織間植入治療是將放射性核素直接植入到腫瘤靶區(qū),通過放射性核doc(編輯修改稿)

2025-08-14 13:27 本頁面
 

【文章內(nèi)容簡介】 n: a feasibility study Int J Radiation Oncology Biol Phys, 2004。60: 928–93218. Trejos AL, Lin AW, Pytel MP, et al. Robotassisted minimally invasive lung brachytherapy. Int J Med Robot,2007。3:4151.19. Johnson M, Colonias A, Parda D, et al. Dosimetric and technical aspects of intraoperative I125 brachytherapy for stage I nonsmall cell lung cancer. Phys Med Biol. 2007。 52:1237124520. Mark G, Trombetta, Athanasios C, et al. Tolerance of the aorta using intraoperative iodine125 interstitial brachytherapy in cancer of the lung. Brachytherapy, 2008。7: 5054三、腹部腫瘤胰腺癌(1)適應(yīng)證:①局部晚期無法手術(shù)切除者;②腫瘤直徑<7cm;③腫瘤沒有浸潤大的血管和器官。(2)粒子活度:~(3)推薦粒子劑量:90Gy~110Gy;外放療劑量:45Gy~50Gy;重要臟器劑量應(yīng)與外照射合并計(jì)算。(4)治療原則:①開腹暴露腫瘤。因經(jīng)皮穿刺可能造成腹腔感染、腸瘺、胰瘺等嚴(yán)重并發(fā)癥,不推薦B超或CT引導(dǎo)下經(jīng)皮穿刺植入。②術(shù)中明確病理;③術(shù)中彩色超聲探查腫瘤大小與血管關(guān)系;④超聲指導(dǎo)插植粒子植入導(dǎo)針,間距1cm,~1cm;⑤檢查穿刺針是否誤入血管或胰管;⑥粒子植入后即刻超聲探查,粒子分布不均勻時(shí)在“冷點(diǎn)”區(qū)補(bǔ)充粒子;⑦術(shù)后聯(lián)合外照射+化療;⑧與十二指腸、胃、~。肝門膽管癌(1)適應(yīng)證:①局部晚期無法手術(shù)切除者;②腫瘤直徑7cm;③沒有侵犯大血管;(2)粒子活度: mC~;推薦粒子劑量:90Gy~110Gy。(3)治療原則:①開腹暴露腫瘤;②術(shù)中明確病理;③術(shù)中彩色超聲探查腫瘤大小、與血管關(guān)系,指導(dǎo)插植粒子植入導(dǎo)針;④距離周圍重要器官1cm以上;⑤粒子植入后即刻探查,粒子分布不均勻時(shí)在“冷點(diǎn)”區(qū)補(bǔ)充粒子;⑥術(shù)后聯(lián)合外照射+化療。肝癌(1)適應(yīng)證:①局部晚期無法手術(shù)切除者;②腫瘤直徑7cm;③沒有侵犯大血管;④術(shù)中殘留;⑤介入治療后控制不佳者。(2)粒子活度: mCi~(3)推薦粒子劑量:90Gy~120Gy(4)治療原則:①術(shù)中用彩色超聲探查腫瘤大小、與血管關(guān)系,指導(dǎo)插植粒子植入導(dǎo)針,可采用經(jīng)肝、經(jīng)皮穿刺的方法,植入粒子。②距離周圍重要器官 1cm;③粒子植入后即刻探查,粒子分布不均勻時(shí)在“冷點(diǎn)”區(qū)補(bǔ)充粒子;④術(shù)后聯(lián)合外照射+化療。肝轉(zhuǎn)移癌(1)適應(yīng)證:①腫瘤數(shù)目3個(gè);②單個(gè)病灶直徑<5cm;③沒有肝外轉(zhuǎn)移;④術(shù)中肉眼或鏡下殘存;(2)粒子活度:~,推薦粒子劑量:90Gy~110Gy。(3)治療原則:①CT或彩色超聲引導(dǎo)下進(jìn)行;②邊界以影像學(xué)邊界為準(zhǔn);③間距1cm~;④術(shù)中有腫瘤殘留時(shí)可采用平面插植技術(shù)。參考文獻(xiàn)1. Nag S, Ellis RJ, Martin EW et al. Feasibility study of radioimmunoguided iodine –125 brachytherapy for metastatic colorectal cancer. Radiat Oncol Invest, 1995, 2: 2302362. Nath R, Anderson LL, Luxton G, et al. Dosimetry of interstitial brachytherapy sources: Remendation of the AAPM Radiation Therapy Committee Task Group No Phys, 1995, 22:2092343. Kumar PP, Good RR, Jones EO ,et al. Retreatment of recurrent pelvic tumors with Med, 1989,7:1501594. Holm A, Bradley E, Aldrete J. Hepatic resection of metastases from colorectal carcinoma. Ann Surg, 1988, 209:4284345. Armstrong JG, Anderson LL, Harrison LB, et al. Treatment of liver metastases from colorectal cancer with radioactive implants. Cancer, 1994, 73:180018046. Anderson LL. A spacing nomograph for interstitial implants of 125I seeds. Med Phys, 1976, 3:48517. Kaplan EL, Meier P. Nonparametric estimation for inplete observation. J Am Stat Assoc, 1958, 4:57818. Thomas DS, Dritschilo A. Interstitial highdose irradiation for hepatic : Nag S, ed. High dose rate brachytherapy: a textbook. Armonk, NY: futura Publishing Company Inc, 1994, 3393469. Martinez MR, Nag S, Nieroda C, et al. Iodine125 brachytherapy in the treatment of colorectal adenocarcinoma metastatic to the liver. Cancer, 1999, 85:12181122510. Dritschilo A, Harter K, Thomas D, et al. Intraoperative radiation therapy of hepatic metastases: technical aspects and report of a pilot study. Int J Radiat Oncol Biol Phys, 1988, 14:1007101111. Hoskins B, Gunderson LL, Dosoretz D, et al. Adjuvant postoperative radiotherapy in carcinoma of the rectum and ,1985,55:617112. Dobrowsky W, Schmid AP. Radiotherapy of presacral recurrence following radical surgery for rectal carcinoma. Dis Colon Rectum,1985, 28:91791913. Nag S. Principle of brachytherapy. In: Nag S, ed. Principle and practice of brachytherapy. Armonk, NY: Futura Publishing Co., 1997:31114. Handley SW. Pancreatic cancer and the treatment by implanted radium. Ann Surg,1934,100:21522215. Henschke UK. Permanent interstitial infusion of inoperable tumors of the thorax and abdomen. Minerva Med, 1973, 58:45314536.16. Peretz T, Nori D, Hilaris B,et al. Treatment of primary unresectable carcinoma of the pancreas with I125 implantation. Int J Radiat Oncol Bio Phys,1989,17:93193517. Shipley WU, Nardi GL, Cohen AM, et al. Iodine125 implant and external beam irradiation in patients with localized pancreatic carcinoma. A parative study to surgical resection. Cancer,1980,45:70971418. Syed AM, Puthawala
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