纤维支气管镜下大剂量腔内放疗治疗癌性支气管阻塞

目的　应用后装设备在纤维支气管镜引导下将192Ir导入支气管内进行腔内放疗,治疗癌性支气管阻塞。方法　常规纤维支气管镜检后,将施源器导管经活检孔导入病变部位,接后装机进行放疗,每次6～8Gy,每周1次,连续3周为1疗程。疗程结束后第1、4周复查。结果　胸部X线检查示:CR15例(23.08%),PR28例(43.08%),MR12例(18.46%),总有效率(CR+PR+MR)为84.62%。纤支镜检查示:CR25例(38.46%),PR28例(43.08%),MR9例(13.85%),总有效率为95.38%。结论　该方法对肺癌引起的支气管阻塞具有良好的再通效果,作用快,疗效好,副作用少。

High-dose endobronchial radiation therapy under fiberoptic bronchoscope for malignant airway obstruction.

Objective To assess the effect of endobronchial radiation guided by fiberoptic bronchoscope for malignant airway obstruction. Methods Sixty five patients with lung cancer and malignant airway obstruction were investigated. After routine bronchoscopic examination, the brachytherapy catheter was inserted through biopsy channel and the tip was fixed onto the obstructing malignancies. Then radiotherapy was performed with 192 Ir at a dose of 6 8 Gy distributed among 2 5 points. The treatment was rendered weekly in a sequence of 3 weeks as one course. The chest X ray and bronchoscopic assessment were made 1 and 4 week after finishing radiation therapy.Results X ray assessment:CR,PR and MR were 23.08%(15 cases),43.08%(28 cases) and 18.46%(12 cases) respectively, with 84.62%of total effective rate (CR+PR+MR). Bronchoscopic assessment: CR, PR and MR were 38.46%(25 cases), 43.08(28 cases) and 13.85%(9 cases) respectively, with 95.38% of total effective rate. Conclusion The endobronchial radiation guided by fiberoptic bronchoscope has better reopening effect and less complications for malignant airway obstruction in the patients with lung cancer.