摘要
背景与目的采用碘125(125I)粒子近距离治疗肿瘤的靶向优势,探讨微创植粒在Ⅲ、Ⅳ期肺癌综合治疗中的应用价值和临床疗效。方法对42例经常规治疗或其它疗法难以控制和部分初治的中晚期肺癌(其中中央型15例)患者,应用三维治疗计划系统(TPS)计算剂量和制定布粒计划,在CT引导下经皮穿刺、单针分次植入125I粒子进行近距离放疗。植粒后CT检查布粒情况和有无并发症。3～7天内同步或分期进行化疗与其它疗法治疗。每3～4周采用胸片、CT、MRI观察肿瘤缩小效果。结果粒子分布满意率为83.3%(35/42)。近期总有效率为85.7%,其中完全缓解率为26.2%(11/42),部分缓解率为59.5%(25/42),无变化率为14.3%(6/42),止痛有效率为83.3%(15/18)。并发轻度出血13例(31.0%),其中肺内渗血8例(19.0%),咯血5例(11.9%);少量气胸3例(7.1%);粒子移位1例(2.4%);全组未发生白细胞降低和放射性肺炎。结论微创植粒创伤小,并发症轻,安全有效,可有选择地应用。
Baekground and objective Brachytherapy offers an innovative method of delivering conformal high-dose radiation to a defining target tumor. The aim of this study is to investigate the value and effect of using radioactivity ^125I seed permanent implants combined with chemotherapy in the management of stage Ⅲ or Ⅳ lung cancer. Methods Forty-two lung cancer patients in stage Ⅲ and Ⅳ （15 center lung cancer） who couldn＇t be relieved by routine methods were treated with ^125I seed permanent micropuncture implant brachytherapy and chemotherapy. The dose and distribution of seeds was decided by treatment planning system, and CT was used during ^125I seed permanent implant treatment. Distribution of seeds and complication was reviewed by CT scan after treatment. Chemotherapy was performed in 3 to 7 days after implanting. The effect was observed by X-ray, CT and MRI every 3 or 4 weeks. Results The satisfaction rate of seed distribution was 83.3% （35/42）. The response rate of treatment was 85.7% （36/42）, including complete response rate 26.2% （11/42）, partial response rate 59.5% （25/42）, no change rate 14.3% （6/42）. Effective rate of pain relief was 83.3 % （15/18）. Thirteen patients （31.0 % ） had complication of mild hemothorax, 8 （19.0 % ） with bleeding in lung and 5 （11.9%） with hemoptysis. Three patients （7.1%） had mild pneumothorax and 1 patient （2.4%） had a malposition seed. Leucopenia and radiation pneumonia didn＇t occurred. Conelusion 125I seed micropuncture implant has less trauma and complication, and is a safe and effective method. This method might be helpful in the treatment of lung cancer and can be selectively used in clinic.
出处
《中国肺癌杂志》
CAS
2005年第6期527-529,共3页
Chinese Journal of Lung Cancer
