CT导引下^125Ⅰ粒子植入治疗周围型非小细胞肺癌

目的：探讨CT导引下^125Ⅰ放射性粒子植入在肺非小细胞肺癌治疗中的作用。方法：22例周围型非小细胞肺癌中，腺癌11例，腺鳞癌4例，鳞癌7例，肿瘤直径约3．5-8．0cm，全部经CT导引下肺穿刺活检病理证实。根据三维治疗计划系统（TPS），在CT导引下使用粒子针行肿瘤组织间^125Ⅰ种植，粒子活度0．8mCi，6例辅以化疗，2例补充放疗，CT随访进行疗效评价。结果：22例中，^125Ⅰ粒子种植后6个月CT评价，布源满意率86．36％（19／22），3例完全缓解（13．63％，3／22）；14例部分缓解（63．64％，14／22），5例无变化（22．73％，5／22），总有效率77．27％（17／22）。随访6～38个月，1、2、3年生存率分别为63．6％（14／22）、31．8％（7／22）、13．6％（3／22），中位生存时间14个月。结论：CT导引下经皮穿刺植入^125Ⅰ放射性粒子，对非小细胞肺癌的疗效较好，创伤小。

Treatment of Peripheral Non-small Cell Lung Cancer by CT-guided 125I Seeds Implantation

Objective： To investigate the value of CT guided ^125Ⅰ radioactive seeds implantation in the treatment of non-small cell lung cancer （NSCLC）. Methods： There were 22 cases with peripheral NSCLS included adenocarcinoma （11 cases）,adenosquamous carcinoma （4 cases） and squamous cell carcinoma （7 cases）. The diameter of tumor ranged from 3. 548.0cm. All were diagnosed by CT-guided needle aspiration biopsy of lung. According to three dimensional treatment planning system （TPS）,implantation of ^125Ⅰ seeds permanently in tumor tissues was performed under CT-guidance, the activity of seeds was 0.8mCi. Six cases received adjuvant chemotherapy and two cases had complementary radiotherapy. Ther apeutic efficacy was evaluated by follow-up CT scanning. Results： All 22 cases were investigated 6 months after ^125Ⅰ seeds implantation,the satisfaction rate of seeds distribution was 86. 36% （19/22 cases）, Three cases had complete remission 13.63% （3 / 22 cases）; 14 cases had partial remission 63. 64% （14/22 cases）; no change were assessed in 5 cases （22. 73%,5/22 cases）. Tthe total effective rate was 77. 27% （17/22 cases）. These patients were followed up for 6-38 months,the 1.2.3 year survival rates were 63.6% （14/22 cases） ,31.8% （7/22 cases） and 13.6% （3/22 cases） respectively, the median of survival time was 14 months. Conclusion：Implantation of radioactive ^125Ⅰ seeds via percutaneous puncture of lung under CT guidance had relative satisfactory therapeutic short-term effects and mild injury for non-small cell lung cancer.