125I粒子植入治疗腹膜后淋巴结转移中国专家共识（2024版）
本共识由中国多学科专家基于文献检索与临床经验制定，涵盖放射性碘-125粒子间质近距离治疗腹膜后淋巴结转移的适应证、禁忌证、植入方法、穿刺路径、剂量及手术流程等关键环节。共识旨在为临床医生、护士及医学物理师提供规范化的操作参考，提升不同临床场景下该技术的标准化与同质性。
要点
- 碘-125粒子植入适用于腹膜后淋巴结转移的间质近距离治疗，需严格把握适应证与禁忌证。
- 操作涉及穿刺路径规划、粒子剂量计算与植入方法选择，需多学科协作完成。
- 共识强调标准化流程以减少并发症并提高局部控制率，适合影像引导下操作参考。
核心结论
- 共识具备较高的科学严谨性与实用适用性，可为腹膜后淋巴结转移的碘-125粒子植入提供临床指导。
研究设计与样本
- 由中国放射肿瘤、外科、介入放射、肿瘤内科、超声及核医学等领域专家组成多学科专家组制定。
- 检索关键词包括「iodine 125 seed implantation」「interstitial brachytherapy」「retroperitoneal lymph node metastases」「computed tomography-guided」「125I seeds」。
- 基于文献复习与临床经验形成初稿，经全体专家反馈及集中讨论后定稿。
关键影像表现/征象
- 共识涉及穿刺路径选择，需在影像引导下避开周围重要结构以安全抵达腹膜后淋巴结转移灶。
- 粒子植入方法及剂量分布需结合病灶位置、大小及毗邻关系进行个体化规划。
诊断标准与关键数值
- 共识涵盖适应证、禁忌证、植入方法、穿刺路径、剂量及手术操作流程等关键条目，具体数值由临床方案决定。
临床应用与阅片要点
- 放射科或超声科医生可作为影像引导操作者参与穿刺路径设计、术中定位及粒子分布验证。
- 报告应描述病灶与周围血管、肠管、输尿管等结构的毗邻关系，为粒子植入安全规划提供依据。
局限性
- 共识制定基于专家经验与现有文献，未提供证据分级或推荐等级。
- 共识未披露具体剂量阈值、粒子活度范围或并发症发生率等定量数据。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
OBJECTIVE: In order to standardize the operational techniques for 125I seed interstitial brachytherapy for retroperitoneal lymph node metastases, we organized multidisciplinary experts to develop the ".
CHINESE EXPERT CONSENSUS: radioactive iodine 125 seed interstitial brachytherapy for retroperitoneal lymph node metastases (2024 edition)."
METHOD: In the development of this consensus, we convened a multidisciplinary panel of leading Chinese medical experts specializing in seeds implantation from the fields of radiation oncology, surgery, interventional radiology, Department of Medical Oncology, ultrasonography, and nuclear medicine.
THE PROCESS PROCEEDED AS FOLLOWS: first, a literature search was conducted using keywords such as "iodine 125 seed implantation," "interstitial brachytherapy," "retroperitoneal lymph node metastases," "computed tomography-guided," and "125I seeds." Based on the reviewed literature and extensive clinical experience, the writing committee drafted the initial document. This draft was then distributed to all panel members for broad feedback and suggestions. Finally, a centralized discussion was held to integrate the collective expertise and finalize the consensus statements.
RESULT: The main contents of this consensus include indications, contraindications, implantation methods, puncture paths, dosage, surgical procedures, and other key points.
CONCLUSION: This consensus document demonstrates a high degree of scientific rigor and practical applicability. It is designed to provide clinical guidance for the implementation of 125I seed brachytherapy for retroperitoneal lymph node metastases. By establishing clear, evidence-based recommendations, it aims to serve as a reliable reference for clinicians, nurses, and medical physicists involved in the procedure. Ultimately, this consensus seeks to enhance the standardization and procedural homogeneity of 125I seed brachytherapy for retroperitoneal lymph node metastases across different clinical settings.
引用
- Wang, Zhang, Zhang, et al. Chinese expert consensus: Radioactive iodine-125 seed interstitial brachytherapy for retroperitoneal lymph node metastases (2024 edition). J Cancer Res Ther. 2026. PMID: 42241160. doi:10.4103/jcrt.jcrt_1737_24
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。