摘要
目的探讨支气管超声内镜(EBUS)引导下125I放射性粒子植入治疗纵隔淋巴结转移肿瘤的可行性及观察近期疗效。方法对2014年9月至2015年3月在重庆医科大学附属第二医院呼吸内科就诊的20例纵隔淋巴结转移肿瘤患者行EBUS引导下^(125)I放射性粒子组织间植入治疗,观察近期疗效并回顾性分析其治疗纵隔淋巴结转移肿瘤的可行性。结果 20例纵隔淋巴结转移肿瘤患者接受EBUS引导下^(125)I放射性粒子植入短距离放射治疗操作过程顺利,所有患者耐受性良好,无一例死亡。并发症包括术中穿刺部位出血3例(15%),术后气胸4例(20%),低热5例(25%),咯血7例(35%),经对症治疗后均缓解。术后每2个月随访胸部CT,共随访6个月,测量肿瘤直径及评估患者生理状态,按照WHO实体瘤评价标准(RECIST),术后2、4、6个月的临床有效率[完全缓解率+部分缓解率]分别为65.00%(13/20)、80.00%(16/20)、85.00%(17/20)。5例上腔静脉综合征患者经上述治疗后,临床症状缓解明显,随访6个月后症状缓解达100.00%,无放射性粒子移位及上腔静脉再狭窄发生。结论EBUS引导下^(125)I放射性粒子植入术治疗纵隔淋巴结转移肿瘤创伤小、并发症少、近期疗效显著,能有效缓解上腔静脉压迫症状,是一种可行、安全、有效的措施。
Objective To investigate the feasibility of endoscopic bronchial ultrasonography（EBUS）guided iodine-125（125I）radioactive seeds implantation for treating mediastinal metastatic tumor and to observe its short term curative effect. Methods Twenty patients with mediastinal metastatic tumor in the respiration department of our hospital from September 2014 to March2015 were treated by the EBUS-guided iodine-125 radioactive seeds interstitial implantation. The short-term effects were observed and the feasibility for treating mediastinal metastatic tumor was retrospectively analyzed. Results The operation procedure of the EBUS-guided iodine-125 radioactive seeds implantation brachytherapy in 20 cases of mediastinal metastatic tumor was successful.All cases had good tolerance without death case. The complications included intraoperative bleeding at puncture site in 3 cases（15%）,postoperative pneumothorax in 4 cases（20%）,low fever in 5 cases（25%）,hemoptysis in 7 cases（35%）,which were alleviated after symptomatic treatment. Postoperative follow-up chest CT was carried out every 2 months in all cases. The tumor diameter and physical status of all patients were obtained during follow-up. The response evaluation criteria in solid tumors（RECIST）were used to evaluate the therapeutic effect,the overall response rates（CR＋PR） at postoperative 2,4,6 months were 65.00%（13/20）,80.00%（16//20） and 85.0%（17/20）respectively. The clinical symptoms in 5 cases of superior vena cava syndrome（SVCS） were significantly improved by the above treatment and the symptom alleviation reached 100.00% after 6-month follow up. No radioactive seeds shift and restenosis of superior vena cava occurred in any case. Conclusion The EBUS-guided iodine-125 radioactive seeds implantation for treating mediastinal metastatic tumor has small trauma,few complications and obvious short term effect,can effectively alleviate the pressure symptoms of superior vena cava,which is a feasible,safe and effective measure.
出处
《现代医药卫生》
2016年第11期1638-1641,共4页
Journal of Modern Medicine & Health
