摘要
背景与目的纵隔内恶性肿瘤位置深邃、隐匿,手术切除可能性极小。由于其紧邻心包、主气管、大血管等重要解剖结构,氩氦刀冷冻及热消融同样受到限制。本文比较43例放射性^(125)I粒子植入患者的影像复查资料和生存质量,探讨其操作安全性和临床疗效。方法 2010年7月-2011年7月经病理证实并完成随访的43例患者,其中原发纵隔型肺鳞癌21例,原发食管癌9例,淋巴结转移癌13例。合并主气道50%以上狭窄18例,食管梗阻9例,上腔静脉回流障碍6例。每个病灶植入^(125)I粒子10枚-60枚,平均(30.79±14.23)枚。治疗后2个月、4个月、6个月及12个月复查CT观察局部病灶控制情况,并对患者生存质量及生存期进行随访。结果全部操作技术成功率100%,最长随访时间12个月,6个月生存37例,6个月生存率为85.0%,局部病灶PR 30个,NC 7个,临床有效率为81.08%,临床受益率为100%。12个月生存31例,1年生存率为60.5%,局部病灶CR 16个,PR7个,NC 2个,PD 6个,临床有效率为74.19%,临床受益率为80.65%。6个月、12个月KPS评分提高且差异明显穿刺导致气胸3例(6.98%),无大血管、主气管、喉返神经及心包损伤等严重并发症。结论放射性^(125)I粒子植入治疗纵隔内恶性肿瘤,技术成功率高且相对安全,临床疗效肯定。
Background and objective The locations of mediastinal malignant tumor lesions are deep and occult, and are close to the pericardium,trachea,or major vessels.Therefore,the possibility of surgical resection is slim,and cryoablation and thermal ablation are restricted.In current study,image and life quality data were compared before and after ^(125)I seeding therapy to investigate its safety and clinical effects.Methods From July 2010 to July 2011,a 43-patient follow-up of pathologically confirmed cancers,including 21 cases of primary mediastinal squamous lung cancer,9 cases of primary esophagus cancer, and 13 cases of lymph node metastases were completed.Among these,18 cases presented with tracheal stenosis >S0%,9 cases had esophageal obstruction,and 9 cases had superior vena cava reflux disorder.Each lesion was implanted with 10 to 60 pieces of ^(125)I particles,with an average of 30.79±14.23.CT data at 2,4,6,and 12 months after therapy were obtained to evaluate the local lesion outcome.The quality of life of the patients as well as survival data was also recorded.Results The overall success rate of the operation was 100%.The longest time of follow-up was 12 months.At 6 months,37 patients were alive,and the half-year survival rate was 85.0%.In terms of local lesions,30 cases of PR and 7 cases of NC were found.The clinical effective rate was 81.08%,and the clinical beneficial rate was 100%.At 12 months after therapy,31 patients were alive,and the one-year survival rate was 60.5%.In terms of local lesions,16 cases of CR,7 cases of PR,2 cases of NC,and 6 cases of PD were found. The clinical effective rate was 74.19%,and the clinical beneficial rate was 80.65%.The KPS score increased after the treatment (P=0.000).Three cases of pneumothorax presented after treatment,and no severe complications,such as vessel,trachea,recurrent laryngeal nerve,or pericardiocentesis injuries,were found.Conclusion Radiation seed implantation in mediastinal malignant tumors is a relatively safe technique with high success rate,considerable efficacy,and clear clinical value in advanced cancer treatment.
出处
《中国肺癌杂志》
CAS
2011年第12期933-937,共5页
Chinese Journal of Lung Cancer
