摘要
目的采用CT引导下单针植入^(125)I粒子治疗肺部恶性肿瘤。方法收集整理赤峰松山医院肺部恶性肿瘤患者150例,术前完善治疗计划系统(TPS),并在CT引导下单针植入^(125)I粒子。结果 150例患者,男性105例,女性45例,年龄40~63岁,平均年龄55±4岁,卡氏评分(KPS)≥70分。并对肿瘤的完全缓解(CR)、部分缓解(PR)、病情稳定(SD)、病变进展(PD)、复发以及肿瘤引起的胸痛、胸闷、咳嗽、咳痰、胸腔积液及上腔静脉综合征症状改善率和各种不同病理类型进行统计。150例中第1个月、第3个月、第6个月及第12个月的有效率分别为:38.0%、54.0%、67.3%、75.3%。第1个月、第3个月、第6个月及第12个月的复发率分别为:0、1.3%、1.3%、1.3%,总体复发率为4.0%。胸痛、胸闷、咳嗽、咳痰、胸水及上腔静脉综合征第1个月、第3个月、第6个月及第12个月的改善率分别为:17.6%、41.2%、64.7%、88.2%;20.8%、43.7%、69.7%、85.4%;18.6%、52.9%、77.4%、91.1%;17.2%、31.0%、43.6%、67.8%;11.1%、33.3%、77.7%、77.7%;25%、50%、87.5%、100%。上腔静脉综合征及咳嗽症状改善率最好,且组间差异有统计学意义(P<0.05)。第1个月、第3个月、第6个月及第12个月的有效率分别为:鳞癌33.3%、50.0%、66.6%、79.1%,腺癌27.1%、50.8%、66.1%、71.1%,小细胞癌16.6%、33.3%、66.6%、91.6%,大细胞癌15.3%、30.7%、53.8%、69.2%,转移瘤0%、12.5%、37.5%、50.0%,淋巴瘤20%、50%、70%、90%。小细胞癌和淋巴瘤的疗效较好,但总体组间差异无统计学意义(P>0.05),仅第12月有效率有统计学意义(P<0.05)。鳞癌、腺癌、小细胞癌、大细胞癌、转移瘤及淋巴瘤的1年生存率分别为:100%、100%、100%、75%、100%、100%。结论单针植入^(125)I粒子治疗肺癌的有效率较高,尤其是在小细胞癌的应用上,并对肿瘤引起的刺激症状、压迫气管及上腔静脉阻塞综合征的缓解最为有效,是一种微创的有效治疗方法。
Objective To guide the single needle ^125I particle implantation in the treatment of pulmonary malignant tumor by CT. Methods A total of 150 patients with lung cancer in Chifeng Songshan hospital were collected and treated with CT（TPS） before operation and ^125I particles were implanted under the guidance of single needle. Results of the 150 patients, there were 105 males and 45 females, aged 40 to 63 years old, with the average age of 55.3 years,and Karnofsky score more than 70 points（KPS）. The rates of CR, PR, SD, PD, recurrence, chest pain, chest tightness,cough, expectoration, pleural effusion and superior vena cava syndrome, as well as various pathological types were statistically analyzed. The effective rates of the first month, the third month, the sixth month and the 12 th month were38.0%, 54.0%, 67.3% and 75.3%, respectively. The recurrence rates in the first month, third month, sixth month and12 th month were 0%, 1.3%, 1.3% and 1.3% respectively, and the overall recurrence rate was 4%. As for chest pain,chest distress, caugh, coughing up phlegm, hydrothorox and superior vera cava syndrme. The first month, the third,sixth months and 12 th months, the improvement rate were 17.6%, 41.2%, 64.7%, 88.2%; 20.8%, 43.7%, 69.7%,85.4%; 18.6%, 52.9%, 77.4%, 91.1%; 17.2%, 31%, 43.6%, 67.8%; 11.1%, 33.3%, 77.7%, 77.7%, 25%, 50%;87.5%, 100%. Superior vena cava syndrome and cough symptom improvement rate is best, with statistically significant（P〈0.05）. The effective rate of the first month, the third, sixth months and 12 th months were as fouous： 33.3%, 50.0%,66.6%, 79.1% for squamous cell carcinoma, 27.1%, 50.8%, 66.1%, 71.1% for adenocarcinoma, 16.6%, 33.3%, 66.6%and 91.6% for small cell carcinoma, 15.3%, 30.7%, 53.8%, 69.2% for large cell carcinoma,0%, 12.5%, 37.5%, 50%for metastasis, 20%, 50%, 70%, 90% for lymphoma. The curative effect of small cell carcinoma and lymphoma was better, but there was no statistical significance between the two groups（P〉0.05）. The effective rate in December was statistically significant（P〈0.05）. The one-year survival rates of squamous cell carcinoma, adenocarcinoma, small cell carcinoma, large cell carcinoma, metastatic tumor and lymphoma were 100%, 100%, 100%, 75%, 100%, 100%, respectively. Conclusion single needle implantation of ^125I for treatment of lung cancer has high efficiency, especially in the application of small cell carcinoma, and the tumor causing irritation, and relieve the obstruction of the superior vena cava syndrome compression of the trachea is most effective, which is an effective method for minimally invasive.
作者
乔英
徐向阳
孙立彬
兰艳
Qiao Ying, Xu Xi- angyang, Sun Libin, Lan Yan.(Department of CT/MR room, Chifeng Songshan Hospital, Mongolia, Inner Mongolia 024005, China)
出处
《实用医学影像杂志》
2018年第3期209-212,共4页
Journal of Practical Medical Imaging
