【摘要】 目的　评价CT导向下12 5I粒子植入治疗肺转移瘤的临床价值。方法　 18例肺转移瘤患者 ,男 10例 ,女 8例 ,年龄 35～ 73岁 ,中位年龄 5 6 2岁 ,其中肝癌肺转移 10例 ,直肠癌肺转移 6例 ,乳腺癌肺转移 2例。 18例病灶数为 6 8个 ,平均每人 3 8个病灶 ,病灶平均直径为 2 5cm。在CT导向下将12 5I粒子植入肺转移瘤灶内 ,采用治疗计划系统 (TPS)计算布源 ;对残留厚度≤ 1 0cm的肿瘤选择平面植入方法 ,采用 18 5～ 2 9 6MBq活度的12 5I粒子相隔 1 0～ 1 5cm平面播植 ,12 5I在 1 7cm内具有杀灭肿瘤的作用。结果　 18例 6 8个病灶 ,完全缓解 (CR) 36个 ;部分缓解 (PR) 17个 ;无变化 (NC) 10个 ;进展 (PD) 5个。总有效率 77 9%。术中肺内有少量渗出 ;2例出现气胸 ,肺压缩均在 30 %以内 ,经保守治疗好转 ;术后 1周痰中带血 15例。 2个月随访过程中发生粒子移位 2例 (肺内 ) ;白细胞下降 2例 ,程度较轻 ,计数均在 3× 10 9/L以上。未见其他严重并发症。结论　放射性粒子植入治疗肺部转移瘤临床疗效好 ,创伤小 ,并发症发生率低更多还原

【Abstract】 Objective To investigate the clinical value of CT guided radioactive seed ¹²⁵I implantation in treating lung metastasis. Methods From October, 2002 to July, 2003, 18 patients （male 10, female 8, median age 56.2） with lung metastasis accepting CT guided radioactive seeds ¹²⁵I implantation were enrolled in this study. Among these patients, 10 cases had primary liver cancer, 6 cases had primary rectal cancer, and 2 cases had breast cancer. 18 patients totally had 68 metastatic lesions （mean diameter 2.5 cm）. Under CT guidance, ¹²⁵I seeds were implanted into lung metastasis according to TPS. For tumor with remanent width less than 1 cm, plane implantation technique was adopted with ¹²⁵I seeds of 0.5-0.8 mCi at a distance of 1.0-1.5 cm.Results Among 68 lesions in 18 cases, 36 obtained CR, 17 PR, 10 NC, and 5 PD. The response rate was 77.9%. The side effects occurred during the procedure including few effusions in all patients and pneumothorax in 2 cases with lung compressed less than 30 percent. Blood in sputum occurred in 15 cases 1 week after the procedure and seeds migration occurred in 2 cases during 2 months follow up. WBC decreased slightly in 2 cases 2 weeks after the procedure, but WBC count ≥3×10⁹/L. No other severe complications were seen.Conclusion CT guided radioactive seed ¹²⁵I implantation procedure has good clinical effects in treating lung metastasis with minimal damage and few complications.更多还原