【正文】 生活質(zhì)量：Quality of life（QOL）。局部控制率：local control（LC）。遠(yuǎn)期療效評(píng)價(jià)腫瘤進(jìn)展時(shí)間：time to progression（TP）。腫瘤治療療效評(píng)價(jià)近期療效評(píng)價(jià)完全緩解：plete response（CR）。適形指數(shù)：Conformation index（CI）。評(píng)估參數(shù)靶體積比：target volume ratio（TVR）。計(jì)劃靶體積：planning target volume（PTV）。最小周邊劑量：minimum peripheral dose（mPD）。毫居：mCi（1Ci=100mCi）。低劑量率：Low dose rate（LDR）。永久植入：permanent implantation。34:71772516. Wallner K, Roy J, Harrison L, et al. Dosimetry guidelines to minimize urethral and rectal morbidity following transperineal I125 brachytherapy. Int J Radiat Oncol Biol Phys, 1995。 10:152412. Wallner K. Iodine125 brachytherapy for early stage prostate cancer: new techniques may achieve better , 1991。130:2832868. Terris MK, Stamey TA. Determination of prostate volume by transrectal ultrasound. J urol, 1991。 68:5105224. Whitmore WF Jr, Hilaris B, Grabstald H. Retropublic implantation of iodine125 in the treatment of prostate Urol, 1972。并發(fā)癥（1）會(huì)陰部腫脹；（2）泌尿系癥狀：排尿困難、尿急、尿頻、血尿和尿儲(chǔ)留等；（3）直腸癥狀：排便疼痛、直腸出血和里急后重等；（4）性功能障礙；（5）粒子遷移到其它器官可能引起的并發(fā)癥?；颊邷?zhǔn)備：（1）術(shù)前患者或家屬簽署放射性粒子永久植入治療知情同意書(shū)；（2）術(shù)前腸道準(zhǔn)備。（2）匹配周邊劑量：?jiǎn)渭兞Ｗ又踩胫委煟?25I粒子為145Gy；103Pd為110Gy。禁忌證：絕對(duì)禁忌證：（1）預(yù)計(jì)生存期5年；（2）TURP后缺陷嚴(yán)重或預(yù)后不佳；（3）一般狀況差；（4）有遠(yuǎn)處轉(zhuǎn)移。粒子治療加外照射：（1）Ｔ２ｂ～Ｔ２ｃ；（2）Gleason分級(jí)7～10；（3）PSA 10ng/ml；（4）周?chē)窠?jīng)受侵；（5）多點(diǎn)活檢陽(yáng)性；（6）雙側(cè)活檢陽(yáng)性；（7）MRI提示前列腺包膜外侵。注意事項(xiàng)：（1）粒子植入治療需要在CT引導(dǎo)下實(shí)施；（2）；（3）轉(zhuǎn)移腫瘤邊界以影像學(xué)邊界為準(zhǔn)；（4）既往有外照射史者慎重，對(duì)術(shù)后復(fù)發(fā)者，建議粒子植入后加外照射；（5）推薦術(shù)后即刻質(zhì)量驗(yàn)證；（6）局部浸潤(rùn)麻醉。參考文獻(xiàn)Kumar PP, Good RR, Jones EO ,et al. Retreatment of recurrent pelvic tumors with Med, 1989。直腸癌術(shù)后復(fù)發(fā)（1）適應(yīng)證：①盆腔腫瘤術(shù)后復(fù)發(fā)；②直徑＜7cm；③因手術(shù)禁忌癥無(wú)法實(shí)施再次手術(shù)；或患者拒絕手術(shù)。（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)。肝癌（1）適應(yīng)證：①局部晚期無(wú)法手術(shù)切除者；②腫瘤直徑7cm；③沒(méi)有侵犯大血管；④術(shù)中殘留；⑤介入治療后控制不佳者。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。 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。15:37138116. D’Amato TA, Galloway M, Szydlowaki G, et al. Intraoperative brachytherapy following thoracoscopic wedge resection of stage I lung cancer. Chest, 1998。179–181.12. Nori D, Li X, Pugkhem T. Intraoperative brachytherapy using Gelfoam radioactive plaque implants for resected stage III nonsmall cell lung cancer with positive margin: A pilot study. J Surg Oncol, 1995。51:666–670.11. Rafael Mart253。15:371381.7. Alex chen. Intraoperative 125I brachytherapy for highrisk stage I nonsmall cell lung carcinoma. Int J Radiat oncol Biol Phys, 1999。 75:2372433. Rafael Mart. Percutaneous CTguided 103Pd implantation for the medically inoperable patient with T1N0M0 nonsmall cell lung cancer: A case report. Brachytherapy，2004。（5）推薦實(shí)施術(shù)后質(zhì)量驗(yàn)證。注意事項(xiàng)：（1）經(jīng)皮穿刺粒子植入治療需要借助CT引導(dǎo)，術(shù)中可以采用彩色超聲引導(dǎo)。建議使用模板，確保粒子治療精度。粒子活度：～推薦粒子劑量：（1）單純粒子治療MPD：90Gy～110Gy；（2）聯(lián)合外照射酌情減量。參考文獻(xiàn)1 Vikram B, Mishra S. Permanent iodine125 boost implants after external radiation therapy in nasopharyngeal cancer. Int J Radiat Oncol Biol Phys, 1994, 28:6997012 .Harrison LB, Weissberg JB . A technique for interstitial nasopharyngeal brachytherapy. Int J Radiat Oncol Biol Phys, 1987, 13:4514533 .Wei WL, Facs FD, Jonathan ST, et al. Splitpalate approach for gold grain implantation in nasopharyngeal carcinoma. Arch Otolaryngol Head Neck Surg , 1990, 116:5785824 .蔡德江，李平，鄭志堅(jiān),，1997，6：80835 .Martinez A, Goffinet DR, Fee W, et al . Iodine125 implants as an adjuvant to surgery and external beam radiotherapy in the management of locally advanced head and neck cancer. Cancer,1983,51:9739796 .Crook J, Mazeron J, Marinello G, Martin M, et al. Combined external irradiation and interstitial implantation for T1 and T2 epidermoid carcinomas of base of tongue. Int J Radiat Oncol Biol Phys, 1988,15:1051147 .Esche BA, Haie CM, Gerbault AP, et al . Interstitial and external radiotherapy in carcinoma of the soft palate and uvula. Int J Radiat Oncol Biol Phys,1988,15:6196258 .Putawala AA, Syed AM, Eads DL, et al . Limited external beam and interstitial Iridium192 irradiation