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Ultrasound-guided radioactive 125I particle implantation for the treatment of advanced gallbladder cancer is susceptible to factors such as ribs, respiratory activity, and biliary reflex, which brings great inconvenience to the operation. We reported one case of gallbladder cancer patients with unclear ultrasound imaging under general anesthesia mechanical ventilation and successful transplantation after sustained inflation with general anesthesia in order to providing basis of clinical diagnosis and treatment.
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Objective To investigate the safety and efficacy of transarterial chemoembolization (TACE) combined with implantation of irradiation IVC stent in treating hepatocellular carcinoma (HCC)complicated by inferior vena cava tumor thrombosis (IVCTT).Methods The clinical data of 61 consecutive patients with HCC complicated by IVCTT were retrospectively analyzed.Irradiation IVC stent was prepared by strapping 125I particles on the bare stent,and it was employed in 33 patients (group A).Bare stent was adopted in 28 patients (group B).Propensity score matching method was used to conduct randomized analysis of the original data in order to reduce the selection bias.The survival time,remission rate of symptom and procedure-related adverse events of both groups were calculated and the results were compared between the two groups.Results The incidence of adverse reactions was similar in the two groups,and symptomatic treatment with internal medicine was adopted.The survival time in group A was superior to that in group B.The median survival time in group A was (203.0±28.1) days,which was (93.0±24.3) days in group B (P=0.006).Propensity score matching (24 pairs in total) cohort analysis showed that the median survival time was (200±31) days in group A and (66±23) days in group B (P=0.019).The edema remission rates in group A and in group B were 97.0％ and 96.4％ respectively.Multiple factor analysis revealed that irradiation stent implantation and objective tumor response were independent factors predicting a good prognosis.Conclusion For the treatment of HCC associated with IVCTT,TACE combined with irradiation stent implantation is safe and effective,this therapy can prolong the patient's survival time
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How to study a method that can significantly improve the therapeutic gain ratio of malignant tumor is one of the problems must be solved in the field of cancer therapy. However, how can effectively treat malignancy patients with contraindications of operation, radiotherapy and chemotherapy has been a difficult problem in cancer therapy. The 125I brachytherapy was suitable for malignancy patients with contraindications of operation, radiotherapy and chemotherapy. The guidance of multimodal imaging could contribute to the definitions of tissue density imaging target and biological target, and could ensure the targeting and conformity of treatment. Using the quality assurance and quality control measurements (QA/QC) optimized by radiation dosimetry; using therapy planning system (TPS) to make plan, and adopt optimizing radiation dosimetry and dose volume histogram (DVH) to evaluate TPS, and using image to guide particle implantation and adopt series of methods, such as real-time location verification, dosimetry verification post-implantation, therapy efficacy determination, follow-up and so on, to improve therapeutic gain ratio and partially control therapy efficacy, and then significantly reduce adverse reaction. All of these have important clinical value for increasing survival rate and quality of life.
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Objective To evaluate the clinical value of CT-guided 125I particle implantation combined with iliac artery infusion chemotherapy in treating refractory and recurrent pelvic malignant tumors.Methods A total of 35 patients with refractory and recurrent pelvic malignant tumor,who were admitted to authors' hospital during the period from January 2013 to January 2016 to receive CT-guided 125I particle implantation combined with iliac artery infusion chemotherapy,were selected and used as the study group,while other 39 patients with refractory and recurrent pelvic malignant tumor received simple 125I particle implantation and were used as the control group.The short-term and long-term curative effect,as well as the improvement of clinical symptoms,were compared between the two groups.Results The objective effective rate and the benefit rate in the study group were 60.0％ (21/35) and 85.7％ (30/35) respectively,while those in the control group were 53.8％ (21/39) and 84.6％ (33/39) respectively,the differences between the two groups were not statistically significant (P=0.594 and P=0.894 respectively).In the study group the mean disease progressionfree period was 12.2 months,which was 3.6 months longer than that of 8.6 months in the control group,the difference between the two groups was statistically significant (P=0.002).The recurrence rates in the study group and the control group were 40.0％(12/30) and 57.6％ (19/33) respectively,the difference between the two groups was statistically significant (P=0.018).The mean preoperative and postoperative KPS values in the study group were 72.4 points and 82.7 points respectively,which in the control group were 68.9 points and 79.1 points respectively;in each group statistically significant difference existed between the preoperative KPS value and the postoperative one (P=0.043 and P=0.039 respectively),however,no statistically significant difference in postoperative KPS value existed between the study group and the control group (P=0.745).Conclusion For the treatment of refractory and recurrent pelvic malignant tumors,CT-guided 125I particle implantation is an effective therapy,however,combination use of iliac artery infusion chemotherapy can reduce the incidence of tumor recurrence and prolong the disease progression-free period.
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Objective To investigate the efficacy of implantation of radioactive iodine-125 (125I) seeds combined with chemotherapy in treatment of stage Ⅲb and Ⅳ non-small cell lung cancer (NSCLC).Methods Ninety patients with stage Ⅲb and Ⅳ NSCLC were divided into two groups.The combined group (n=43) received chemotherapy with TP (paclitaxe plus cispla tin) or GP (gemcitabine plus cisplatin) 3 days after 125I particles implantation,and the control group (n=47) only received TP or GP chemotherapy.The effective rate,1-year and 2-year survival rate,the median survival time were compared between the 2 groups.Results The total effective rates of the combined group and the control group of stage Ⅲ b NSCLC were 84.00％ and 48.28％,and the effective rates of stage Ⅵ NSCLC were 72.22％ and 33.33％ (both P＜0.05).The 1-year and 2-year survival rate of the combined group and control group of stage Ⅲb NSCLC were 67.80％,36.00％ and 37.90％,13.83％,respectively (both P＜0.05).The median survival time was 15.7 months and 8.6 months.However,the survival rates of the combined group and the control group of stage Ⅳ NSCLC were 44.44％,16.70％ and 22.22％,11.10％,respectively,while the difference was not statistically significant (P＞0.05).The median survival time was 8.9 and 6.0 months.Conclusion The implantation of radioactive 125I seeds combined with chemotherapy can obtain a significant efficacy in the treatment of stage Ⅲb and stage Ⅳ NSCLC.For patients with stage Ⅲb NSCLC,combined therapy can improve the survival rate.
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Objective To investigate the efficacy of implantation of radioactive iodine-125 (125I) seeds combined with chemotherapy in treatment of stage Ⅲb and Ⅳ non-small cell lung cancer (NSCLC).Methods Ninety patients with stage Ⅲb and Ⅳ NSCLC were divided into two groups.The combined group (n=43) received chemotherapy with TP (paclitaxe plus cispla tin) or GP (gemcitabine plus cisplatin) 3 days after 125I particles implantation,and the control group (n=47) only received TP or GP chemotherapy.The effective rate,1-year and 2-year survival rate,the median survival time were compared between the 2 groups.Results The total effective rates of the combined group and the control group of stage Ⅲ b NSCLC were 84.00％ and 48.28％,and the effective rates of stage Ⅵ NSCLC were 72.22％ and 33.33％ (both P＜0.05).The 1-year and 2-year survival rate of the combined group and control group of stage Ⅲb NSCLC were 67.80％,36.00％ and 37.90％,13.83％,respectively (both P＜0.05).The median survival time was 15.7 months and 8.6 months.However,the survival rates of the combined group and the control group of stage Ⅳ NSCLC were 44.44％,16.70％ and 22.22％,11.10％,respectively,while the difference was not statistically significant (P＞0.05).The median survival time was 8.9 and 6.0 months.Conclusion The implantation of radioactive 125I seeds combined with chemotherapy can obtain a significant efficacy in the treatment of stage Ⅲb and stage Ⅳ NSCLC.For patients with stage Ⅲb NSCLC,combined therapy can improve the survival rate.
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Objective To explore the clinical effect of psychological nursing pathway for patients with hepatocellular carcinoma (HCC) who are receiving 125I particle implantation therapy.Methods A total of 130 HCC patients,who were scheduled to receive 125I particle implantation therapy,were randomly and equally divided into the study group and the control group with 65 patients in each group.Traditional routine psychological nursing method was conducted for patients of the control group,while routine psychological nursing that was based on psychological nursing pathway was carried out for patients of the study group.The patient's conditions of both groups were evaluated by using self-rating anxiety scale (SAS),trait coping style questionnaire (TCSQ) and the quality of life assessment scale (SF-36).The results were statistically analyzed with t test.Results After nursing intervention,SAS scores of the study group and the control group were (43.76±6.25) and (46.16±7.19) points respectively,the difference between the two groups was statistically significant (t=-3.92,P＜0.001).The PC and NC values of the TCSQ score in the study group were (41.61±4.82) points and (20.53±5.88) points respectively,while those in the control group were (37.32±4.62) and (22.80±6.93) respectively,the differences between the two groups were statistically significant (t=5.944 and t=-3.316 respectively,P＜0.01).One month after discharge,the mental health scores of the study group and the control group were (74.58±8.68) points and (71.53±8.16) points respectively,the emotion function scores were (79.46±10.05) points and (75.13±15.09) points respectively,and the differences in both mental health score and emotion function score between the two groups were statistically significant (P＜0.05).Conclusion Standardized psychological nursing pathway can make nurses more clear about the content of psychological nursing work and enable nurses to actively plan and complete psychological nursing care measures,so that patients can get prospective,individual and comprehensive psychological care to alleviate his or her negative emotion,and to improve the quality of life.
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Objective To investigate the technical points and the clinical effectiveness of transcatheter arterial chemoembolization (TACE) combined with CT-guided ~(125)I radioactive particle implantation for the treatment of liver cancer. Methods Twenty-seven patients with hepatic cancer, proved by color Doppler ultrasonography, CT and AFP, were enrolled in this study. All the patients received embolization therapy with lipiodol not long before. Of the 27 patients, preoperative CT scanning was performed in 16. Based on the CT findings, the therapeutic protocol was formulated to determine the amount and site of ~(125)I radioactive particle to be implanted. When drawing the outline of target area, the targeted sedimentation extent which was delineated on CT scan should be exceeded the area with deposits of lipiodol by 0.5-1.0 cm. The average energy of ~(125)I radioactive particle was 27-35 keV. Results Of 27 patients, complete remission was seen in 2, partial remission in 16, unchanged condition in 6 and exacerbation of the condition in 3, with a total efficiency of 66.7%. The patients were followed up for 6 months. One patient died of distant metastasis and the remaining ones survived so far. Conclusion Transcatheter arterial chemoembolization combined with CT-guided ~(125)I radioactive particle implantation is a safe and effective treatment for liver cancer.