CT引导下肿瘤四维立体定位精确穿刺弓箭射频消融治疗肺癌

目的在CT引导下,应用研制的肿瘤四维立体定位精确穿刺弓箭对肺内肿瘤进行定位穿刺和射频消融,观察定位穿刺和射频消融的效果。方法 2010年5月至2012年6月,选择61例患者(69个肿瘤),在CT引导下,利用肿瘤四维立体定位精确穿刺弓箭进行定位和穿刺,利用肿瘤精确放射治疗计划系统,对穿刺到位情况和消融灶范围进行验证评估,采用RITA多极射频肿瘤消融仪对每个肿瘤进行射频消融,采用胸部CT和SPECT对消融效果进行评估。结果 104个肿瘤(较大肿瘤分割后重新计数)定位穿刺均一次完成,无重复穿刺;穿刺误差1~4 mm,平均2.6 mm;104个消融灶完全包含预消融肿瘤。术后1个月复查CT,病灶大小与原肿瘤相比变化不明显,但SPECT显示所有病灶完全无核素浓度。术后3个月复查CT,肿瘤缩小者82.6%(57/69),无肿瘤增大者,3例患者发现肺内转移灶,占4.92%(3/61),复查SPECT,消融灶均无核素浓度。结论利用CT引导和肿瘤四维立体定位精确穿刺弓箭,进行肺内肿瘤定位穿刺和射频消融,定位精确,穿刺准确,锚状电极形成的消融灶可以完全包含肿瘤体积,消融彻底安全。

Radiofrequency under the guidance of 4 dimensional stereo CT tumor location system for lung cancer

Objective To investigate the efficiency of puncture under the guidance of 4 dimension stereo CT tumor location system. Methods From May 2010 to June 2012, 61 patients with 69 tumors were included. We used the 4 dimensional CT tumor stereo location system to locate the tumors and precise radiotherapy planning system to evaluate accuracy of puncture. RITA multipolar radiotherapy system was used to handle each tumor site. After treatment, CT and SPECT was used to evaluate the treatment efficacy. Results The puncture of 104 tumor location（ after division of large tumor） was successful for once, no repetitive puncture was needed. The magin of error of puncture was 1-4 mm with an average of 2.6 mm; 104 puncture location included all the target tumors. 1 month after treatment, CT was pertbrmed, no significant change was observed, but SPECT showed no sign of radionuelide aggregation. 3 months after treatment, 82.6% （57/69） of tumor showed sign of shrink and no enlarge- ment was observed. Intrapulmonary metastases were detected in 3 （3/61） patients. SPECT was performed and no radionuelide aggregation was noted. Conclusions 4 dimensional stereo CT tumor location system is accurate in locating tumor sites and anchor-shaped polar radiofrequency is effective in treating lung cancer.