CT引导下经皮穿刺植入放射性125I粒子治疗肺癌的临床应用

目的 探讨CT引导下经皮穿刺植入放射性125I粒子的肺癌治疗方法,观察临床疗效和不良反应.方法 于2004年6月-2005年10月,经CT引导125I粒子植入治疗肺癌32例.所有病例均行术前TPS制定治疗计划,术后质量验证.全部患者均植入0.5 mCi-1.0 mCi的放射性粒子,12-60颗.结果 植入病例全部成功,无死亡,部分出现气胸、出血,术后1周复查外周血象、1月复查CT及临床观察无毒副反应,术后定期复查CT,未出现放射损伤症状,未发现粒子脱落或游走等并发症.CR 22.58%、PR 61.29%、SD 12.9%、PD 3.2%.中位生存期大于12个月.结论 CT引导下经皮穿刺放射性125I粒子近距离照射治疗肺癌安全、有效,并且创伤小、并发症少.

Clinical application of 125I seed implantation in lung carcinoma guided by CT

Objective To explore the therapy method of ~(125)I seed implantation in lung carcinorma guided by CT and to observe the clinical effect and adverse response. Methods From June, 2004 to October, 2005, 32 patients with lung carcinoma accepting CT guided radioactive seed ~(125)I implantation were enrolled in this study. All cases were performed according to the treatment planning system (TPS) before operation, then the radioactive dose was validated. Every patient was implanted into radioactive seed of 0.5 mci- 1.0 mci in does and 12-60 in quantities. Results All implantation cases were satisfactive, no death occurred, but pneumothorax and blooding in partial cases. There is no toxic response in reexamination of peripheral blood hemogram one week after treatment, of CT one month after operation and clinical observation; whereas periodic CT found no symptom of radioactive trauma and no complication of dropping, migrating and so on. Among lung carcinoma in 32 patients, 22.58 % obtained CR, 61.29 % obtained PR, 12.9 % CD and 3.2 % PD. Mediam survival time (MST) was more than 12 months. Conclusion The brachytherapy of ~(125)I seed implantation in lung carcinoma guided by CT is safe and effective, with less traumas and complications.