Research On Early Radioactive Injure In Sciatic Nerve Of Rats And The Treatment In The Recurrence Rectal Carcinoma Pain With Interstitial Implantation Of ¹²⁵I Seeds

Radioactive seeds cure malignant tumor in long history, which develop quickly in recent decade and become the example of the best shape. The Interstitial implantation of 125I Seeds applied generally in carcinoma of prostate because of high incidence rate in Europe and America. It has standardized in the treatment of carcinoma of prostate after scholar aboard had done much research and clinical work. They often try the application in the other stereo-cancer and make better clinical curative effect. The exploration brings new hope in the treatment of recur-nasopharyngeal carcinoma, middle–advaned stage head and neck tumor , malignant lung tumor,liver cancer, pancreatic carcinoma, rectal cancer, and so on.The Interstitial implantation of 125I Seeds applies widely in the clinic because of the predominance of longer half period,low energe,low dose rate,continuous irradiation and simple protection and so on.It can not only diminish tumor,but also relieve the different degree of pain without severe complication,which provides a new method for the cure of carcinoma pain. The related and systemic research has not been reported in domestic and abroad. Through animal experiment, We approach Early Radioactive Injure in Sciatic Nerve of Rats, which applies in the clinic in order to discuss the effectiveness and influencing factor in the treatment of recur-rectal cancer pain.PartⅠResearch on Early Radioactive Injure in Sciatic Nerve of Rats and P with Interstitial implantation of 125I SeedsObjective: To study Pathological change and tolerated dosage of interstitial brachytherapy with 125I seeds of different dosage in Sciatic nerve of rats.Methods: 64 wistar rats were randomly divided into four groups: control group, experimental group(A group,B group,C group).Vacant source was implanted into control group, 80Gy,120Gy,160Gy 125I seeds into experimental group. After 30 and 60 days drew the materials to study Pathological and GDNF change of the radiated nerve through light microscope , transmisson electron microscope and, Pathological image analied with nerve fibre diameter,myelin sheath thickness and GDNF average optical density value .Results: 30d:To study ischium nerve through light microscope, In 80Gy,120Gy groups fibre bundle edema, In 160Gy group cell nucleus delet and light karyotin,phlegmasia cell infiltration. Transmisson electron microscope, In 80 Gy,120Gy groups myelin sheath hyperplasy lightly, In 160Gy group hyperplasy in midrage degree,mitochondrial crista and membrane fusion or vanish. Pathological image analysis results: nerve fibre diameter , myelin sheath thickness and GDNF average optical density value . There was significant difference between 160Gy group and other groups(P<0.05). Among the rest groups difference had not statistics significance(P>0.05). 60d: ischium nerves have similar results with 30d through light microscope and transmisson electron microscope. Pathological image analysis results: nerve fibre diameter and transmisson electron microscope. Pathological image analysis results: nerve fibre diameter, myelin sheath thickness and GDNF average optical density value. There was significant difference between 160Gy group and other groups(P<0.05). Among the rest groups difference had not statistics significance(P>0.05). Each experimental group had not significant difference between 30d and 60d(P>0.05).Conclusion: Sciatic nerve injury depends on dosage. 120Gy perhaps is tolerated dosage for Sciatic nerve. PartⅡResearch on the treatment in the recurrence rectal carcinoma pain with interstitial implantation of 125I SeedsObjective: To discuss clinical analysis and influential factors in the Recurrence Rectal Carcinoma Pain with Interstitial implantation of 125I Seeds.Methods: It was retrospective analyzed that 10 cases Recurrence Rectal Carcinoma was cured with Interstitial implantation of 125I Seeds, including 2 cases inⅠgrade pain, 4 inⅡgrade pain, 4 inⅢgrade pain. According to interstitial treatment planning system, matched peripheral dose was planned 80Gy~120Gy. Pain remission rate, and pain remission period were evaluated after operation.Results: The 6 of 10 Rectal Carcinoma patients got complete pain remission (CR), 2 got partial pain remission (PR), The overall pain remission rate was 80%.Beween 80Gy to 120 Gy in matched peripheral dose, pain remission beginning time diminished with the dose increased, which showed negative correlation (R=-0.9847) through dependability statistical analysis and Difference had statistics significance (P<0.001). Pain remission period was related with the dose(R=0.0199), which there was statistics significance (P>0.05). The 3 of 10 Rectal Carcinoma patients got complete tumor remission (CR), 2 got partial tumor remission (PR), 2 got NC, 0 got PD. Of 3 in complete tumor remission, 3 patients got complete pain remission(CR), The overall pain remission rate was 100%; Of 5 in partial tumor remission, 3 patients got complete pain remission (CR), 2 got partial tumor remission (PR), The overall pain remission rate was 100%; Of 2 in tumor NC, 2 got pain MR. Compared tumor NC with combining tumor CR and PR, there were not statistics significance (P=0.02). 1 patient withⅠdegree pain got 1 pain CR, pain remission rate was 100%; 5 patients withⅡdegree pain got 3 pain CR, 1 got PR, which pain remission rate was 80%; 4 patients withⅢdegree pain got 2 pain CR, 1 got PR, 1 got MR, which pain remission rate was 75%. There were not statistics significance (P>0.05) in intergroup.Conclusion: Interstitial implantation of 125I Seeds is very fast and effective for relief of rectal carcinoma pain, which can boost life quantity. The matched peripheral dose and tumor effect influenced remarkably the analgesic efficacy of 125I Seeds for cancer pain, while pain degree before treatment not.