最新(核医学课件)17.2放射性核素治疗教学讲义ppt.ppt

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1、(核医学课件)17.2放射性核素治疗PheochromocytomaOriginatefromchromaffincells(嗜铬细胞）90%locatedinadrenalmedulla（肾上腺髓质）Producingandreleasingcatecholamines（儿茶酚胺）leadtoparoxysmal（陈发性）orpersistenthypertensionandothersymptoms.10-20%ofpheochromocytomaismalignancy（恶性）Diagnosisbiochemicalstudiesurinaryandbloodtest：c

2、atecholamines，catecholaminemetabolitesImagingtechniquesCTandMRI:highlysensitive,nonspecificMIBGscanning:highlyspecific,lesssensitiveContraindicationPregnantorbreastfeedingWBC<4.0X109,RBC<3.5X109,PLT<9X109KidneyfailureProcedurefor131I-MIBG131I-MIBGimagingstudytodosimetricestimates.Stopdrugkno

3、wntoreduceMIBGuptakeand/orretention7daysbeforetreatment.Thyroidblockadewithlugol‘ssolution(复方碘溶液）131I-MIBGinfusionfor2hourswithcontinuouspulse,BPandECGmonitoring.Post-therapyscintigraphicimagingstudiesWeeklyfullbloodcountsaswellashepaticandrenaltestsforatleast6weeksAssessmentofresponseusingc

4、ombinedCT/MRI/bonescan/MIBGimagingbeforethesubsequentcourse.TherapeuticdosageFixeddose100-300mCiEstimatedby131IMIBGtumoraluptakeretentionofthetracerdosethevolumeofthetumorRetreat4-12monthintervalSideeffectshort-termsideeffectsnauseaandanorexia（恶性及纳差）vomitting（呕吐）riseinbloodpressurelongtermsi

5、deeffectslowbonemarrowdepressionEfficacyevaluation95%Pheochromocytomaisabletouptake131IMIBGPurposeoftreatmentinclude:symptompalliationtumorfunctionreductiontumorarresttumorregressioneffectivepoweris70%Normal131I-MIBGanteriorandposteriorwholebodyscanshowingphysiologicalsalivarygland,myocardia

6、landhepaticuptakewithrenalandgastrointestinalexcretion.131I-MIBGisalsousuallytakenupbytheadrenalglands.Summary131I-MIBGisaneffectiveandsafetreatmentmodality.Treatmentwithmultipledosesiswell-toleratedandgenerallyleadstosymptomaticrelief.ithaslittletoxicity.Thankyou!放射性肺炎（radiationpneumonitis）

7、定义系由于肺癌、乳腺癌、食管癌、恶性淋巴瘤或胸部其他恶性肿瘤经放射治疗后，在放射野内的正常肺组织受到损伤而引起的炎症反应。症状多于放射治疗后2～3周出现症状症状轻者无症状，炎症可自行消散；重者肺脏发生广泛纤维化，导致呼吸功能损害，甚致呼吸衰竭。症状常有刺激性、干性咳嗽、伴气急、心悸和胸痛，不发热或低热、偶有高热。症状气急随肺纤维化加重呈进行性加剧、容易产生呼吸道感染而加重呼吸道症状。并发放射性食管炎时出现吞咽困难。若放射损伤肋骨，产生肋骨骨折，局部有明显压痛。体征体检见放射部位皮肤萎缩、变硬