摘要
目的探讨CT引导下经皮穿刺植入125I粒子组织间近距离治疗非小细胞肺癌(NSCLC)的技术可行性、临床疗效和不良反应。方法植入治疗NSCLC95例。所有病例术前TPS制定治疗计划,术后质量验证。肿瘤处方剂量110～120Gy,质量验证D90>100Gy,V90>93%,如剂量不足,重新补种粒子或外照射。结果植入病例全部成功,无死亡,1年后局控率达83.92%。术后有16例咯少量血痰,51例中心型肺癌患者中有11例出现气胸,44例周围性肺癌患者中有6例出现气胸;7例胸腔闭式引流,10例经过胸穿排气处理后自然缓解。胸痛缓解100%(32/32),胸闷、气短缓解83.33%(70/84),阻塞性肺炎治愈95.24%(40/42),咯血治愈91.43%(32/35),上腔静脉梗阻好转100%(18/18)。治疗期间未出现胸腔出血、放射肺炎症状,未发现粒子脱落或游走等并发症。结论CT引导下经皮穿刺植入125I粒子组织间近距离治疗NSCLC安全、有效,且创伤小、并发症少。
Objective To explore the feasibility, clinical effect and side effect of percutaneous implant iodine-125 seeds brachytherapy for the non-small cell lung cancer by CT guiding. Methods 95 patients with non -small cell lung cancer were implanted ^125I seeds by CT guiding from December 2002 to May 2004. All patients were evaluated with TPS（Treatment Plan System） preoperatively and the post-operatiue quality was verified. The tumor prescription dose was about 110-120Gy. D90〉100Gy, V90〉93%. Results All patients succeeded in implanting ^125I seeds and had no mortality. The local contral rate was 83.92% one year after operation. Only 16 cases （16/95, 16.84%） had haemoptysis, pneumothorax happed in 11 eases with central type （11/51, 21.56%） and 6 cases with peripheral type （6/44, 13.64%）, and thoracic closing drainage was employed in 7 patients, and thoracentesis was applied in 10 patients. The cured rate of chest pain,breathe lessness, emphraxis pneumonia, haemoptysis, obstruction of superior vena cava were 100%（32/32）, 83.33%（70/84）,95.24%（40/42）, 91.43% （32/35）, and 100% （18/18） respectively. No complicatons of bleeding in thoracic carity, radioactive preumonia and the seeds fallen off or shifted were found. Conclusions Clinical application of pereutaneous implant iodine-125 seeds braehytherapy for the nonsmall cell lung cancer by CT-guided puncture is a safe, effective method with minimal damage and complication.
出处
《北京医学》
CAS
2005年第8期462-464,共3页
Beijing Medical Journal
基金
河北省卫生厅2004年医学科学研究重点项目计划(课题号04039)
