摘要
目的探讨CT引导下经皮穿刺125I粒子植入治疗肺癌临床应用的安全性及疗效。方法回顾性分析30例经肺穿刺活检、组织学或细胞学检查确诊的肺癌,其中鳞癌13例,腺癌8例,转移性肺癌9例。采用治疗计划系统(TPS)重建肺癌的三维图像,计算出125I粒子植入的数量和剂量分布率,肿瘤匹配周边剂量为80～130 Gy。中位植入粒子35颗(8～83颗)。结果30例患者术后1、3、6、12个月随访,中位生存时间12个月(7～18个月),6、9、12个月累计生存率分别为100%、80.0%、23.3%,随访至12个月肿瘤完全缓解(CR)9例,部分缓解(PR)14例,无变化(NC)4例,进展(PD)3例,1、3、6、12个月总有效率(CR+PR)分别为83%、80%、80%、77%。术后随访发生气胸3例,咯血痰7例。结论CT引导下经皮穿刺125I粒子植入治疗肺癌是一种相对安全、有效、微创的方法。
Objective To investigate the safety and clinical efficacy of CT-guided radioactive ^125I seed implantation treatment for advanced lung cancer. Methods The clinical data of thirty cases with lung cancer, which was proved by puncture biopsy, histology or cytology, were retrospectively analyzed. The pathologic diagnoses included squamous cell carcinoma （n = 13）, adenocarcinoma （n = 8） and metastatic lung cancer （n = 9）. Using treatment planning system （TPS） 3D images of the tumor were reconstructed, the number and the dose rate distribution of ^125I seeds were calculated. The matched peripheral dose （MPD） of ^125I seed implantation was 80 - 130 Gy. The median amount of implanted ^125I seeds was 35 （8 - 83） in number. Results Follow-up observation was made at 1, 3, 6 and 12 months after the treatment in all patients. The median survival time was 12 months （7 - 18 months）. The cumulative survival rate at 6, 9 and 12 months was 100.0%, 80.0% and 23.3%, respectively. Follow-up CT images 12 months after the therapy showed that complete relief （CR） was seen in 9 cases, partial relief （PR） in 14 cases, no change （NC） in 4 cases and progression （PD） in 3 cases. The overall effective rate （CR ＋ PR） of 1-month, 3- month, 6-month and 12-month was 83%, 80%, 80% and 77%, respectively. During following-up period, pneumothorax occurred in 3 cases and bloody sputum occurred in 7 cases. Conclusion CT-guided radioactive ^125I seed implantation treatment is a safe, effective and minimally-invasive treatment for lung cancer.
出处
《介入放射学杂志》
CSCD
北大核心
2009年第9期677-680,共4页
Journal of Interventional Radiology
关键词
肺癌
碘放射性同位素
CT引导
介入治疗
lung cancer
iodine isotope
CT-guidance
intcrventional treatment
