新疆医科大学学报

目的 探讨放射性粒子立体定向近距离消融治疗(RSABT)肝癌合并门静脉癌栓的可行性。方法 回顾性分析2021年7月-2024年4月在新疆医科大学附属肿瘤医院接受RSABT治疗的肝癌合并门静脉癌栓患者14例。处方剂量为100～150 Gy。收集比较术前术后剂量学参数，包括临床肿瘤靶区体积(CTV)、D₉₀、D₁₀₀、V₉₀、V₁₀₀、V₁₅₀、V₂₀₀。采用配对t检验比较术前与术后所对应的参数。结果 手术成功率为100%。14例患者的术前、术后剂量学参数对比差异均无统计学意义(P>0.05)。术后D₁₀₀均值较术前略升高，术后CTV、D₉₀、V₉₀、V₁₀₀、V₁₅₀、V₂₀₀和术前比较有变化，但差异无统计学意义(P>0.05)。1例患者术后出现肝周积液、积血，给予针道纤维铂金弹簧圈填塞后好转。结论 RSABT治疗肝癌合并门静脉癌栓术前术后剂量学参数无明显差异，可达到剂量学要求，并发症发生率低且可控，是一种较为安全的治疗方法。

Objective To investigate feasibility of radioactive seed stereotactic ablation brachytherapy(RSABT) for hepatocellular carcinoma(HCC) combined with portal vein tumor thrombus. Methods Retrospective analysis of 14 patients with HCC combined with portal vein tumor thrombus who underwent RSABT from July 2021 to April 2024 in the hospital. The prescribed dose was 100-150 Gy. Dosimetric parameters were collected for comparison between preoperative and postoperative dosimetric parameters, including CTV volume, D₉₀, D₁₀₀, V₉₀, V₁₀₀, V₁₅₀ and V₂₀₀. Paired t-tests were used to compare the parameters corresponding to preoperative and postoperative periods. Results Surgical success rate was 100%. The comparison of preoperative and postoperative dosimetric parameters in 14 patients showed no statistically significant differences(P>0.05). The mean D₁₀₀ after the operation was slightly higher than that before the operation. There were changes in CTV, D₉₀, V₉₀, V₁₀₀, V₁₅₀ and V₂₀₀ after the operation compared with those before the operation, but the differences were not statistically significant(P>0.05). One patient developed perihilar effusion and hematoma after surgery, which improved after coil embolization of the needle tract. Conclusion There was no significant difference in the preoperative and postoperative dosimetric parameters of RSABT for the treatment of HCC combined with portal vein tumor thrombus, and the dosimetric requirements can be met with a low and controllable complication rate, which makes it a safer treatment method.