PDF(Pubmed)
Abstract：
UNASSIGNED: To investigate the feasibility and evaluate the safety and effectiveness of Computed Tomography (CT) guided125I radioactive particle implantation for treating lymph node metastases in radioiodine-refractory differentiated thyroid cancer (RAIR-DTC). To verify the accuracy of the computerized three-dimensional treatment planning system (TPS) in treating lymph node metastasis using125I particle implantation at the dosimetric level.
UNASSIGNED: A retrospective analysis was conducted on 42 patients with RAIR-DTC and lymph node metastases who were admitted to the General Hospital of the Northern Theater Command between December 2016 and January 2019. During this analysis, physicians utilized preoperative CT images to design an intraoperative plan using TPS. The dosimetric parameters of the postoperative plan were then compared to the preoperative plan. Additionally, this study examined the changes in tumor size and tumor-related marker Thyroglobulin (Tg) values in patients at 2, 6, and 12 months after the operation.
UNASSIGNED: The number of125I radioactive particles implanted in 42 patients was 226, with an average of 14.5 (range 2.0-30.0) particles implanted per lesion. The local remission rates were 97.62% (41/42), 88.10% (37/42), and 85.71% (36/42) at 2, 6, and 12 months postoperatively, respectively. The volume of the lesions was (4.44 ± 1.57) cm3, (4.20 ± 1.70) cm3, and (4.23 ± 1.77) cm3at 2, 6, and 12 months after treatment, respectively, which significantly decreased from the preoperative baseline level of (6.87 ± 1.67) cm3(t-values: 9.466, 9.923, 7.566, all P<0.05). The Tg levels were 15.95 (5.45, 73.93) μg/L, 8.90 (2.20, 39.21) μg/L, and 6.00 (1.93, 14.18) μg/L at 2, 6, and 12 months after treatment, respectively, which were significantly lower than the preoperative baseline levels of 53.50 (20.94, 222.92) μg/L (Z values: -5.258, -5.009, -4.987, all P < 0.001). Postoperatively, Delivered to 90% of the GTV(D90) was slightly lower than the prescribed dose in 95.23% (40/42) of patients, but the difference was not statistically significant [(12,378.8 ± 3,182.0), (12,497.8 ± 1,686.4) cGy; t=0.251, P>0.05], and postoperative dose parameters delivered to 100% of the gross tumor volume (GTV)(D100) (6,881.5 ± 1,381.8) cGy, the volume percentages of GTV receiving 150% of the prescribed dose(V150) (58.5 ± 18.40)%) were lower than the preoperative plan D100 (8,085.8 ± 2,330.0) cGy, V150 (66.5 ± 17.70)%; t-value=8.913 and 3.032, both P<0.05; the remaining indicators were not significantly different from the preoperative plan (the differences in the number of implanted particles, Planning Target Volume(PTV), the volume percentages of GTV receiving 100% of the prescribed dose(V100), Homogeneity Index(HI)were not statistically significant (t/Z = -0.593, -1.604, 1.493, -0.663, all P>0.05).
UNASSIGNED: Referring to the TPS preoperative plan, the125I particle implantation therapy for RAIR-DTC lymph node metastasis can achieve the expected dose distribution, ensuring precise short-term local tumor control efficacy.
UNASSIGNED: A retrospective analysis was conducted on 42 patients with RAIR-DTC and lymph node metastases who were admitted to the General Hospital of the Northern Theater Command between December 2016 and January 2019. During this analysis, physicians utilized preoperative CT images to design an intraoperative plan using TPS. The dosimetric parameters of the postoperative plan were then compared to the preoperative plan. Additionally, this study examined the changes in tumor size and tumor-related marker Thyroglobulin (Tg) values in patients at 2, 6, and 12 months after the operation.
UNASSIGNED: The number of125I radioactive particles implanted in 42 patients was 226, with an average of 14.5 (range 2.0-30.0) particles implanted per lesion. The local remission rates were 97.62% (41/42), 88.10% (37/42), and 85.71% (36/42) at 2, 6, and 12 months postoperatively, respectively. The volume of the lesions was (4.44 ± 1.57) cm3, (4.20 ± 1.70) cm3, and (4.23 ± 1.77) cm3at 2, 6, and 12 months after treatment, respectively, which significantly decreased from the preoperative baseline level of (6.87 ± 1.67) cm3(t-values: 9.466, 9.923, 7.566, all P<0.05). The Tg levels were 15.95 (5.45, 73.93) μg/L, 8.90 (2.20, 39.21) μg/L, and 6.00 (1.93, 14.18) μg/L at 2, 6, and 12 months after treatment, respectively, which were significantly lower than the preoperative baseline levels of 53.50 (20.94, 222.92) μg/L (Z values: -5.258, -5.009, -4.987, all P < 0.001). Postoperatively, Delivered to 90% of the GTV(D90) was slightly lower than the prescribed dose in 95.23% (40/42) of patients, but the difference was not statistically significant [(12,378.8 ± 3,182.0), (12,497.8 ± 1,686.4) cGy; t=0.251, P>0.05], and postoperative dose parameters delivered to 100% of the gross tumor volume (GTV)(D100) (6,881.5 ± 1,381.8) cGy, the volume percentages of GTV receiving 150% of the prescribed dose(V150) (58.5 ± 18.40)%) were lower than the preoperative plan D100 (8,085.8 ± 2,330.0) cGy, V150 (66.5 ± 17.70)%; t-value=8.913 and 3.032, both P<0.05; the remaining indicators were not significantly different from the preoperative plan (the differences in the number of implanted particles, Planning Target Volume(PTV), the volume percentages of GTV receiving 100% of the prescribed dose(V100), Homogeneity Index(HI)were not statistically significant (t/Z = -0.593, -1.604, 1.493, -0.663, all P>0.05).
UNASSIGNED: Referring to the TPS preoperative plan, the125I particle implantation therapy for RAIR-DTC lymph node metastasis can achieve the expected dose distribution, ensuring precise short-term local tumor control efficacy.
摘要：
■探讨计算机断层扫描（CT）引导下125I放射性粒子植入治疗放射性碘难治性分化型甲状腺癌（RAIR-DTC）淋巴结转移的可行性，并评估其安全性和有效性。验证计算机三维治疗计划系统（TPS）在剂量水平下采用125I粒子植入治疗淋巴结转移瘤的准确性。
■回顾性分析了2016年12月至2019年1月在北部战区总医院收治的42例RAIR-DTC和淋巴结转移患者。在这个分析中,医师利用术前CT图像设计使用TPS的术中计划.然后将术后计划的剂量学参数与术前计划进行比较。此外,这项研究检测了患者术后2,6和12个月时肿瘤大小和肿瘤相关标志物甲状腺球蛋白(Tg)值的变化.
■42例患者植入的125I放射性粒子数量为226个，平均每个病灶植入14.5个（范围2.0-30.0个）粒子。局部缓解率为97.62%(41/42),88.10%（37/42），术后2、6和12个月85.71%(36/42)，分别。治疗后2,6,12个月病灶体积分别为(4.44±1.57)cm3,(4.20±1.70)cm3,(4.23±1.77)cm3,分别,较术前基线水平（6.87±1.67）cm3明显下降（t值：9.466、9.923、7.566，均P<0.05）。Tg为15.95(5.45,73.93)μg/L,8.90(2.20,39.21)μg/L,治疗后2、6、12个月分别为6.00(1.93、14.18)μg/L,分别,显著低于术前基线水平53.50(20.94,222.92)μg/L(Z值:-5.258,-5.009,-4.987,均P<0.001)。术后,在95.23%（40/42）的患者中，给予90%的GTV（D90）略低于处方剂量，但差异无统计学意义[(12,378.8±3,182.0)，(12,497.8±1,686.4)cGy；t=0.251，P>0.05]，和术后剂量参数传递到100%的总肿瘤体积（GTV）（D100）（6,881.5±1,381.8）cGy，GTV接受150%处方剂量的体积百分比(V150)(58.5±18.40)%低于术前计划D100(8,085.8±2,330.0)cGy,V150(66.5±17.70)%;t值=8.913和3.032,均P<0.05;其余指标与术前计划无显著差异(植入颗粒数的差异,规划目标体积(PTV)，接受100%处方剂量(V100)的GTV的体积百分比，均一性指数(HI)无统计学意义(t/Z=-0.593、-1.604、-0.663,均P>0.05)。
■参考TPS术前计划，125I粒子植入治疗RAIR-DTC淋巴结转移能达到预期的剂量分布,确保精确的短期局部肿瘤控制疗效。
■回顾性分析了2016年12月至2019年1月在北部战区总医院收治的42例RAIR-DTC和淋巴结转移患者。在这个分析中,医师利用术前CT图像设计使用TPS的术中计划.然后将术后计划的剂量学参数与术前计划进行比较。此外,这项研究检测了患者术后2,6和12个月时肿瘤大小和肿瘤相关标志物甲状腺球蛋白(Tg)值的变化.
■42例患者植入的125I放射性粒子数量为226个，平均每个病灶植入14.5个（范围2.0-30.0个）粒子。局部缓解率为97.62%(41/42),88.10%（37/42），术后2、6和12个月85.71%(36/42)，分别。治疗后2,6,12个月病灶体积分别为(4.44±1.57)cm3,(4.20±1.70)cm3,(4.23±1.77)cm3,分别,较术前基线水平（6.87±1.67）cm3明显下降（t值：9.466、9.923、7.566，均P<0.05）。Tg为15.95(5.45,73.93)μg/L,8.90(2.20,39.21)μg/L,治疗后2、6、12个月分别为6.00(1.93、14.18)μg/L,分别,显著低于术前基线水平53.50(20.94,222.92)μg/L(Z值:-5.258,-5.009,-4.987,均P<0.001)。术后,在95.23%（40/42）的患者中，给予90%的GTV（D90）略低于处方剂量，但差异无统计学意义[(12,378.8±3,182.0)，(12,497.8±1,686.4)cGy；t=0.251，P>0.05]，和术后剂量参数传递到100%的总肿瘤体积（GTV）（D100）（6,881.5±1,381.8）cGy，GTV接受150%处方剂量的体积百分比(V150)(58.5±18.40)%低于术前计划D100(8,085.8±2,330.0)cGy,V150(66.5±17.70)%;t值=8.913和3.032,均P<0.05;其余指标与术前计划无显著差异(植入颗粒数的差异,规划目标体积(PTV)，接受100%处方剂量(V100)的GTV的体积百分比，均一性指数(HI)无统计学意义(t/Z=-0.593、-1.604、-0.663,均P>0.05)。
■参考TPS术前计划，125I粒子植入治疗RAIR-DTC淋巴结转移能达到预期的剂量分布,确保精确的短期局部肿瘤控制疗效。
