¹²⁵â…  Seed Implantation In Hepatic Metastatic Carcinoma Guided By Ultrasound

Objective: To explore the meaning of interstitial implantation of125I seed on therapy for metastatic cancer of the liver guided byultrasound.Methods: According to preoperative treatment planning system,36cases of metastatic cancer of the liver patients were treated with125I seedimplantation leaded by ultrasound.25cases of male,11cases of female,age from45to89years old, the average is65.5years. Primary tumorsource:15cases of colorectal cancer,11cases of pancreatic cancer,4cases of breast cancer,3cases of gastric cancer,2cases of ovarian cancer,1case of thymoma cancer.6cases of cancer that located in the left lobe,19cases in the right lobe,11cases in the left and right. All patientsdiagnosed by clinically、serum tumor markers (AFP、CEA、CA19-9、CA15-3、 CA12-5)、 ultrasound、 CT、 MRI、 PET-CT、 biopsy orpostoperative pathology. All patients review the liver CT after theoperation for quality evaluation, and replant125I seed at radiate cold areasunder the guidance of TPS. Postoperative, given chemotherapy basis ofpatient’s condition. Make a statistics analysiss of local tumer control rateof3、6months, and demonstrate the advantages of125I therapy.Results:31cases patients for adjuvant chemotherapy after particleimplantation. Of those5cases refused (among three chemotherapyintolerance、one89years of age、one refused chemotherapy). Review ofliver CT at3、6months later, and compare the diameter with pre-implantation, respectively. CT scans after3months: one case CR,22cases PR,9cases NC,4cases PD; effective in23cases, the efficiency is63.8%. CT scans after6months:3cases CR,23cases PR,4cases NC,6cases PD; effective in26cases, the efficiency is72.2%. Followed-up for5to16months,12cases occurred tumor progression, including6patientsof treatment was invalid,6cases achieved CR or PR after progress, onecase occurred in the original place、one case of chest wall、brainmetastasis、one case of lung metastasis、one case of liver、spleen、lungwide metastasis、2cases of abdominal metastasis.9cases was died oftumor progression. The survival rate of one-year was77.7%.36patientsafter particle implntation,8cases (22.2%) appeared pain and discomforton puncture site, tolerable;3cases (8%) in peripheral blood leukocytesdecreased slightly, after conservative treatment were normal range;1case(2%) appears abdominal bleeding, after hemostasis、fluid handling better;1case (2%) appeared particle lung metastasis, had no discomfort. No caseof radiation hepatitis、enteritis、biliary fistula、biliary tract infections、liver and kidney dysfunction.Conclusion:125I seed implantation for hepatic metastatic carcinomaunder the guidance of ultrasound can control the local tumor effectively,and it has advantages of minimally invasion、 safety and lowcomplication, it should be combined chemotherapy.