CT引导下经皮穿刺放射性~(125)I粒子植入治疗肺癌

目的探讨CT引导下组织内植入放射性125I粒子治疗肺癌的临床价值。方法 32例肺癌患者均在植入前采用计算机三维治疗计划系统模拟布源,在螺旋CT引导下将125I粒子植入肿瘤组织内。术后随访12个月并进行CT复查。结果 32例32个病灶共植入125I粒子926粒,平均每个病灶植入28.9粒。2个月后CT复查示,肿瘤完全缓解9例,部分缓解18例,无变化5例,进展0例,总有效率为84%;6个月后,肿瘤完全缓解14例,部分缓解12例,稳定或无变化4例,进展2例,总有效率81%;12个月后,肿瘤完全缓解9例,部分缓解15例,稳定或无变化4例,进展4例,总有效率75%。术中或术后并发症主要有肺内少量出血5例、张力性气胸1例及少量气胸3例。结论 CT引导下经皮穿刺放射性粒子125I组织内永久植入治疗肺癌安全、有效,且创伤小、并发症少。

Curative effect of CT-guided interstitial implantation of 125I on pulmonary carcinoma

Objective To evaluate the clinical value of CT-guided interstitial implantation of 125I seeds for the treatment of pulmonary carcinoma. Methods Thirty-two patients with pulmonary carcinoma underwent CT-guided interstitial implantation of 125I seeds.According to the size of tumor,effective dose,and optimal quantity of 125I seeds to the patient that were computed by a developed algorithm in Treatment Planning System(TPS),the 125I seeds were implanted into the tumor tissues under the guidance of spiral CT.The patients were followed up for 12 months. Results A total of 926 seeds were implanted into the 32 lesions in the 32 cases,28.9 seeds per case in average.The CT scan performed 2 months after the operation showed complete remission(CR) in 9 cases,partial remission(PR) in 18 cases,and no change(NC) in 5 cases.The total effectiveness(CR + PR) rate was 84%.After 6 months later,there were CR in 14 cases,PR in 12 cases,stable or NC in 4 cases,aggravation in 2 cases;the total effectiveness(CR + PR) rate was 81%.After 12 months later,there were CR in 9 cases,PR in 15 cases,stable or NC in 4 cases,aggravation in 4 cases;the total effectiveness(CR + PR) rate was 75%.The mainly intraoperative or postoperative complications were bleeding in lung(5 cases),tension pneumothorax(1 cases),pneumothorax(3 cases). Conclusion CT-guided interstitial implantation of 125I seeds is a safe,effective,minimally invasive,and low complication method for treatment on lung cancer.