3D模板辅助插植近距离治疗在髂血管旁转移淋巴结中的临床应用

doi:10.3760/cma.j.cn113030-20210204-00061

摘要
图/表
参考文献(16)
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要目的初步探讨3D打印模板辅助插植近距离治疗在髂血管旁孤立转移淋巴结的安全性和有效性。方法收集2018—2020年间就诊于河北省沧州中西医结合医院髂血管旁淋巴结转移的 12例患者,应用3D打印模板辅助插植近距离治疗,处方剂量 20~30Gy 1次。疗后前3个月每个月复查CT,3个月后每3个月复查CT,评价治疗局控率、症状缓解率、不良反应。结果 12例患者均顺利完成治疗和随访,1、3、6个月淋巴结达完全缓解分别为2、3、3例,部分缓解分别为9、8、8例,疾病稳定 1例,疾病进展 0例。症状缓解 10例。急性放射性肠炎 2例,骨髓抑制 2例,给予对症处理后好转。结论 3D打印模板辅助插植近距离治疗髂血管旁转移淋巴结可能安全有效、不良反应可耐受。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	鲁洪岭
	孙云川
	肖丽
	尹晓明
	郭威
	杨洪娟
	周建西

关键词 ：三维打印模板, 肿瘤转移,淋巴结/插植近距离疗法, 治疗结果

Abstract：Objective To preliminarily evaluate the safety and efficacy of 3D printing template-assisted brachytherapy in the treatment of solitary metastatic lymph nodes adjacent to iliac vessels. Methods Clinical data of 12 cases of para-iliac lymph node metastasis after radiotherapy admitted to our hospital from October 2018 to April 2020 were retrospectively analyzed. All patients received 3D printing template-assisted brachytherapy at a prescription dose of 20-30Gy/fraction. CT scan was reviewed every 1 month in the first 3 months after treatment and every 3 months at 3 months after treatment.Local control rate, symptom relief rate and adverse events were evaluated. Results All the 12 patients successfully completed the treatment and follow-up. At 1,3 and 6 months after 3D printing template-assisted brachytherapy, 2, 2 and 3 patients obtained complete remission of lymph nodes, 9, 8 and 8 cases of partial remission, 1 case of stable disease and no case of disease progression. The symptoms were relieved in 10 patients. Acute radiation enteritis occurred in 2 patients and myelosuppression in 2 patients, which were mitigated after symptomatic treatment. Conclusion 3D printing template-assisted brachytherapy may be an efficacious and safe treatment of para-iliac lymph node metastasis, which yields tolerable adverse events.

Key words： 3D printing template Neoplasm metastasis,lymph node/brachytherapy after implantation Treatment outcome

收稿日期: 2021-02-04

通讯作者: 孙云川,Email:13932719095@163.com

引用本文:

鲁洪岭,孙云川,肖丽等. 3D模板辅助插植近距离治疗在髂血管旁转移淋巴结中的临床应用[J]. 中华放射肿瘤学杂志, 2021, 30(10): 1036-1040.

Lu Hongling,Sun Yunchuan,Xiao Li et al. Clinical application of 3D template-assisted brachytherapy in para-iliac lymph node metastasis[J]. Chinese Journal of Radiation Oncology, 2021, 30(10): 1036-1040.

链接本文:

http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20210204-00061 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2021/V30/I10/1036

[1] Niebling MG, Wevers KP, Suurmeijer AJ, et al. Deep lymph node metastases in the groin significantly affects prognosis, particularly in sentinel node-positive melanoma patients[J]. Ann Surg Oncol, 2015, 22(1):279-286. DOI:10.1245/s10434-014-3854-8.
[2] Baratti D, Kusamura S, Cabras AD, et al. Lymph node metastases in diffuse malignant peritoneal mesothelioma[J]. Ann Surg Oncol, 2010, 17(1):45-53. DOI:10.1245/s10434-009-0756-2.
[3] Lopes A, Bezerra AL, Serrano SV, et al. Iliac nodal metastases from carcinoma of the penis treated surgically[J]. BJU Int, 2000, 86(6):690-693. DOI:10.1046/j.1464-410x.2000.00862.x.
[4] Collettini F, Schippers AC, Schnapauff D, et al. Percutaneous ablation of lymph node metastases using CT-guided high-dose-rate brachytherapy[J]. Br J Radiol, 2013, 86(1027):20130088. DOI:10.1259/bjr.20130088.
[5] 张宁,程光惠. 宫颈癌腔内联合组织间插植近距离放疗应用进展[J]. 中华放射肿瘤学杂志,2016, 25(8):895-901. DOI:10.3760/cma.j.issn.1004-4221.2016.08.023.
Zhang N, Cheng GH. Recent advances of intracavitary/interstitial brachytherapy in cervical cancer[J]. Chin J radiat oncol, 2016, 25(8):895-901. DOI:10.3760/cma.j.issn.1004-4221.2016.08.023.
[6] 尹晓明,孙云川,胡婷婷,等.¹⁹²Ir高剂量率近距离放疗在结直肠癌术后复发肺内寡转移治疗的初步应用[J]. 中华放射医学与防护杂志,2019, 39(11):833-836. DOI:10.3760/cma.j.issn.0254-5098.2019.11.006.
Yin XM, Sun YC, Hu TT, et al. Preliminary application of ¹⁹²Ir high-dose rate brachytherapy in postoperative recurrent colorectal cancer with intrapulmonary oligometastasis[J]. Chin J Radiol Med Protect, 2019, 39(11):833-836. DOI:10.3760/cma.j.issn.0254-5098.2019.11.006.
[7] He M, Cheng G, Zhao H, et al. EP-1984:interstitial brachytherapy for the isolated lymph node metastasis from different solid cancers[J]. Radiother Oncol, 2016, 119(Supp1):S938-S939.
[8] 姜玉良,吉喆,郭福新,等. CT引导3D打印非共面模板辅助 ¹²⁵I粒子治疗头颈部复发转移癌不良反应研究[J]. 中华放射医学与防护杂志,2017, 37(7):495-499. DOI:10.3760/cma.j.issn.0254-5098.2017.07.004.
Jiang YL, Ji Z, Guo FX, et al. Side effect of radioactive ¹²⁵I seed implantation for recurrent malignant tumor of head and neck assisted by 3D-printing individual guide plate[J]. Chin J Radiol Med Protect, 2017,37(7):495-499. DOI:10.3760/cma.j.issn.0254-5098.2017.07.004.
[9] 吉喆,姜玉良,郭福新,等.3D打印非共面模板辅助CT引导放射性粒子植入治疗胸部恶性肿瘤剂量学评估[J]. 中华放射肿瘤学杂志,2017, 26(7):754-758. DOI:10.3760/cma.j.issn.1004-4221.2017.07.007.
Ji Z, Jiang YL, Guo FX, et al. Dosimetric assessment of CT-guided radioactive seed implantation assisted by 3D printing non coplanar template in treatment of chest malignant tumors[J]. Chin J Radiat Oncol, 2017, 26(7):754-758. DOI:10.3760/cma.j.issn.1004-4221.2017.07.007.
[10] 陈华明,李丰彤,王境生,等. 射波刀治疗 22例髂血管旁淋巴结转移性病变的疗效和预后分析[J]. 中华放射医学与防护杂志,2017, 37(4):278-281. DOI:10.3760/cma.j.issn.0254-5098.2017.04.009.
Chen HM, Li FT, Wang JS, et al. Clinical observation on the treatment efficacy of Cyberbnife for iliac lymph node metastasis[J]. Chin J Radiol Med Protect, 2017, 37(4):278-281. DOI:10.3760/cma.j.issn.0254-5098.2017.04.009.
[11] 于慧敏,张宏涛,何伟,等. CT引导下 ¹²⁵I粒子植入治疗髂血管旁淋巴结转移癌 12例[J]. 介入放射学杂志,2015, 24(12):1072-1076. DOI:10.3969/j.issn.1008-794X.2015.12.011.
Yu HM, Zhang HT, He W, et al. CT guided ¹²⁵I seed implantation for the treatment of lymph node metastasis nearby the iliac vessels preliminary clinical observation[J]. J Intervent Radiol, 2015, 24(12):1072-1076. DOI:10.3969/j.issn.1008-794x.2015.12.011.
[12] Roses RE, Datta J, Czerniecki BJ. Radiation as immunomodulator:implications for dendritic cell-based immunotherapy[J]. Radiat Res, 2014, 182(2):211-218. DOI:10.1667/RR13495.1.
[13] Wattenberg MM, Fahim A, Ahmed MM, et al. Unlocking the combination:potentiation of radiation-induced antitumor responses with immunotherapy[J]. Radiat Res, 2014, 182(2):126-138. DOI:10.1667/RR13374.1.
[14] 王娟,孙美玲,张宏涛,等. 外放疗后复发颈部淋巴结转移癌 17例(125)Ⅰ粒子植入治疗的初步疗效[J]. 介入放射学杂志,2014, 23(9):784-787.
Wang J, Sun ml, Zhang HT, et al. Radioactive ¹²⁵I seed implantation for the treatment of recurrent cervical lymphatic metastases after radiotherapy:preliminary results in 17 cases[J]. J Intervent Radiol, 2014, 23(9):784-787.
[15] 袁香坤,崔芒芒,苗珺珺,等.3D打印微创导向模板在术后复发性宫颈癌近距离治疗中的临床应用[J]. 中国肿瘤临床,2018, 45(24):1258-1262. DOI:10.3969/j.issn.1000-8179.2018.24.883.
Yuan XK, Cui MM, Miao JJ, et al. The clinical application of 3D-printed minimally-invasive guided template in the inter-stitial brachytherapy treatment of postoperative recurrent cervical cancer[J]. Chin J Clin Oncol, 2018, 45(24):1258-1262. DOI:10.3969/j.issn.1000-8179.2018.24.883.
[16] 王皓,王俊杰,姜玉良,等.3D打印模板联合CT引导 ¹²⁵I粒子治疗盆腔复发直肠癌的剂量学分析[J]. 中华医学杂志,2016, 96(47):3782-3786. DOI:10.3760/cma.j.issn.0376-2491.2016.47.003.
Wang H, Wang JJ, Jiang YL, et al. CT guided ¹²⁵I seed implantation for pelvic recurrent rectal cancer assisted by 3D printing individual non-coplanar template[J]. Chin J Med, 2016, 96(47):3782-3786. DOI:10.3760/cma.j.issn.0376-2491.2016.47.003.