523 胸壁 课件

CT引导下125I粒子植入治疗胸壁复发或转移性肿瘤探讨与实践TheInvestigationofCT guidedimplantationof125Iseedsforchestwallmetastasisorrecurrence PingJiang JunjieWangdrjiangping 23 May 2012 背景Background 1 KyobuGeka 2011Jul 64 8Suppl 725 32 JThoracCardiovascSurg2007 133 1 104 10 背景Background 2 JClinOncol2008 26 5113 5118 IntJRadiatOncolBiolPhys2008 70 477 484 背景Background 3 治疗treatment 手术surgery 放疗radiotherapy 无法手术unresectable 复发relapse 再复发re relapse 有效control 背景Background 4 目的Objective 评价125I粒子植入治疗胸壁复发或转移性肿瘤的可行性 有效性及安全性 Toevaluatethefeasibility efficacyandmorbidityofimplantationof125Iseedsforrefractorychestwallmatastasisorrecurrence 材料与方法Methods materials 材料与方法Methods materials 患者一般情况 Characteristicsofpatients n 20 材料与方法Methods materials 材料与方法Methods materials 患者一般情况 Characteristicsofpatients n 20 患者一般情况 Characteristicsofpatients n 20 材料与方法Methods materials 材料与方法Methods materials 术前计划pretreatmentplanning PTV GTV 0 5cm 材料与方法Methods materials 粒子植入技术Seedsimplantationtechnique 粒子距离皮缘 2cmavoidsevereskinreactionbyplacingtheseedsatadistanceof2cmawayfrommarginalskin 材料与方法Methods materials 术后剂量验证postimplantdosimetryevaluation 材料与方法Methods materials 材料与方法Methods materials 结果Results 1 局部疗效localposition RECISTversion1 1 结果Results 2 结果Results 3 Kaplan MeiermethodSPSS13 0 结果Results 4 结果Results 4 结果Results 5 毒副反应Sideeffectsof125Iseedsimplantation RTOG 讨论Discussion 1 手术Surgery围手术期死亡率0to4 5 Riskofperioperativemortalityfrom0to4 5 Hemmatietal 79chestwallmetastasectomy 5 yoverallsurvival40 EurJCardiothoracSurg 2011 讨论Discussion 2 手术Surgery EuropeanJournalofCardio thoracicSurgery19 2001 584 588 AnnThoracSurg2005 80 2032 40 讨论Discussion 3 再程放疗Re irradiation 讨论Discussion 4 Int J RadiationOncologyBiol Phys 2008 70 477 484 Int J RadiationOncologyBiol Phys 2011 IntJClinOncol2004 9 179 183 结论Conclusion CT引导下125I粒子植入治疗胸壁复发或转移性肿瘤是可行的放射治疗手段之一 CTguidedimplantationof125Isee