CT导向下125I粒子组织间植入治疗非小细胞肺癌

目的探讨CT引导下经皮穿刺植入^125I粒子近距离内照射治疗晚期非小细胞肺癌（NSCLC）的方法、疗效及并发症的处理。方法选择21例术前活检证实为NSCLC的患者，根据治疗计划系统（TPS）计算布源，于CT引导下经皮穿刺植入^125I粒子。粒子活度0．5～0．8mCi，间隔1．0～1．5cm多层面植入肿瘤内。术后即刻CT扫描验证，2～6个月复查CT观察粒子在瘤体内的分布、疗效及有无并发症，随访12个月。结果随诊CT复查，21例患者中完全缓解7例；部分缓解12例；稳定（无变化）2例。1年生存率90．5％（19／21）。并发症包括术中气胸6例，咳血2例。未见严重并发疗和治疗相关的放射损伤。结论CT导向下^125I粒了植入治疗NSCLC安全、有效，近期疗效肯定。

CT-guided interstitial implantation of 125I seeds for non-small cell lung cancer

Objective To discuss the technique, therapeutic effect and complications of CT-guided interstitial implantation of ~(125)I seeds for the treatment of non-small cell lung carcinoma (NSCLC). Methods With the help of treatment planning system, CT-guided interstitial implantation of ~(125)I seeds was performed in 21 patients with pathologically-proved NSCLC. Multi-plane implanting technique was adopted and ~(125)I seeds of (0.5 -0.8) mCi were placed at intervals of (1.0-1.5) cm. Checkup CT scan was carried out immediately after the procedure to make sure that the seeds were satisfactorily distributed. Follow-up CT scanning was made (2-6) months after the treatment to survey the distribution of the seeds within the tumor. The curative effect and complications were also evaluated and observed. The patients were followed for 12 months. Results Of 21 cases, complete remission was seen in 7, obvious remission in 12 and partial remission in 2. The one year survival rate was 90.5% (19/21). Complications included pneumothorax (n = 6) and hemoptysis (n = 2). No serious complications or treatment-related radiation injuries occurred. Conclusion CT-guided interstitial implantation of ~(125)I seeds is a safe and effective treatment for NSCLC with reliable short-term therapeutic effect.