经皮肺穿刺近距离放射治疗肺癌的疗效观察

目的：探讨CT导向下经皮肺穿刺125Ｉ粒子近距离放疗对肺癌的近期疗效。方法：对53例肺癌患者在CT导向下经皮肺穿刺，瘤体内植入125Ｉ粒子。观察手术前后局部肿瘤大小、血常规、肝肾功能及免疫指标的变化。结果：对62个病灶行81次穿刺，术后1、2、3、6个月原发部位肿瘤治疗有效率分别为33.87%(21/62)、51.61%(32/62)、91.94%(57/62)、95.16%(59/62)。外周血常规、肝肾功能、免疫功能等指标手术前后无明显变化。5例出现气胸(6.17%)，9例发生咳血(11.11%)。植入后第6个月2例患者出现粒子丢失。结论：CT导向下经皮肺穿刺125Ｉ粒子近距离放疗对肺癌局部控制率高，对血常规、肝肾功能、免疫功能无明显影响,是一种疗效确切、安全简便的肿瘤微创治疗技术。

Brachytherapy by CT-guided percutaneous paracentesis implantation of iodine-125 seeds for lung cancer

Objective: To explore the clinical value of ~(125) I interstitial brachytherapy by CT-guided percutanepus paracentesis.Methods: Implantation of iodine-125 seeds with implanting needle(18-gauge) by optical navigating system was carried out in fifty-three patients with lung cancer.After operation,the size of tumors and the changes of blood were observed.Results: The fifty-three patients,with sixty-two focuses,were given eighty-one punctures and observed for more than six months.Twelve of the patients were implanted again.The response rate of one,two,three and six months after operation was 33.87%(21/62),51.61%(32/62),91.94%(57/62) and 95.16%(59/62) respectively.There were no significant changes in peripheral blood cells,liver functions,renal functions,T cell subgroups and the activity of natural killer cells after operation.Pneumothorax and hemoptysis were seen in 5(6.17%,5/81) and(9(11.11%,)9/81) patients respectively.Conclusion: Brachytherapy by CT-guided percutaneous paracentesis implantation of iodine-125 seeds is effective and safe for the treatment of lung cancer.The complication is rare and easy to treat.