CT 导引下植入125I放射粒子治疗高龄周围型肺癌的临床应用

目的：探讨C T引导下植入125 I放射粒子治疗高龄周围型肺癌的意义及疗效。方法回顾分析我院自2010年1月～2011年6月18例周围型肺癌患者行C T引导下植入125 I放射粒子治疗，临床资料均经病理证实，生存期超过6个月，且失去手术机会或患者不愿行手术治疗，每部位植入放射粒子12～56粒，放射粒子活度为26、30、33 M bp／颗，粒子间距为0．5～1．0cm ，放射性总活度为550～1500M bp ，按照“均匀植入原则”植入。结果术后随访观察肿瘤局部控制率和患者生存率，随访2月病灶CR 13例、PR 3例、NC 2例、PD 0例、RR 88．9％（16／18）；随访6月病灶CR 15例、PR 2例、NC 1例、PD 0例、RR 94．4％（17／18）；随访1年病灶CR 13例、PR 2例、NC 0例、PD 3例、RR 83．3％（15／18）。患者生存情况：治疗后1年，生存率为94．4％（17／18）。并发症：气胸5例，咳血3例，术后并发感染1例，125 I放射性密封籽源迁移或脱落1例。结论植入125 I放射性粒子治疗高龄周围型肺癌，操作安全，并发症少，6月时临床疗效达到最佳，可重复进行。

Application of 125 I radioactive particle implantation by CT guidance in treatment of old patients with peripheral lung cancer

Objective To explore the significance and curative effect the CT guided implantation of 125 I radioactive parti‐cles in treatment of old patients with peripheral lung cancer .Methods The data of 18 patients aged 70 to 86 years old , who suffered with peripheral lung cancer and underwent the CT guided percutaneous puncture implantation of 125 I radioac‐tive particles in our hospital from January 2010 to June 2011 ,were retrospectively analyzed in this work .The series of pa‐tients comprised 11 males and 7 females ,all of whom were confirmed by pathology and expected to be survival for a period of more than 6 months .In addition ,they all lost the operating opportunity or were unwilling to surgery .As for the de‐tailed regimen of CT guided percutaneous puncture implantation of 125 I radioactive particles ,in each part ,the implanted ra‐dioactive particle was 12~56 grain in each part ,radiation particle activity was for 26 ,30 ,33 Mbp/per particle ,particle spacing was 0 .5~1 .0 cm ,and the total radioactive activity was 550~1500 Mbp .The implantation was performed accord‐ing to the ＆quot;uniform implant principle＆quot;.Results The patients were followed up to observe the control rate of local tumors and survival rate .Following up for 2 months ,CR lesions were found in 13 cases ,PR in 3 cases ,NC in 2 cases ,PD in ze‐ro ,and RR was 88 .9% （16/18） .Following up for 6 months ,CR lesions were found in 15 cases ,PR in 2 cases ,NC in 1 case ,PD in zero ,and RR was 94 .4% （17/18） .Following up for 1 year ,CR lesions were found in 13 cases ,PR in 2 ca‐ses ,NC in zero ,PD in 3 cases ,and RR was 83 .3% （15/18） .The survival rate was 94 .4% （17/18） after one year .With respect to the complications ,aerothorax was found in 5 cases ,hemoptysis in 3 cases ,postoperative infection in 1 case ,and migration of 125 I radioactive seal seed source or exfliation in 1 case .Conclusion Implantation of 125 I radioactive particles for the treatment of peripheral lung cancer in the elderly is safe and le