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CT引导下放射性粒子植入治疗肺转移癌
CT-guided Interstitial Implantation of 125I Seeds for Metastatic Lung Carcinoma
【摘要】 目的探讨种植放射性125I粒子治疗肺转移癌的近期疗效。方法82例126个肺转移灶在CT引导下经皮穿刺肿瘤内种植放射性125I粒子,处方剂量80Gy。6个月后复查CT观察肿瘤体积变化,随访2年。结果靶区瘤体接受的平均照射剂量(159.3±34.5)Gy,中位剂量(118.6±33.2)Gy。6个月后复查CT显示肿瘤完全缓解25.4%(32/126),部分缓解64.3%(81/126),无变化6.3%(8/126),进展4.0%(5/126),总有效率89.7%(113/126)。并发气胸12例,咳血痰41例。死亡病例:8~12个月11例,其中恶性纤维组织细胞瘤6例,肺癌3例,直肠癌1例,肝癌1例;13~24个月15例,其中恶性纤维组织细胞瘤4例,肺癌4例,卵巢癌4例,多发骨髓瘤2例,子宫平滑肌肉瘤1例。1年存活71例,存活率86.6%,2年存活56例,存活率68.3%。结论CT引导下经皮穿刺肿瘤内种植放射性125I粒子治疗肺转移癌的近期疗效肯定。
【Abstract】 Objective To evaluate the short-term effect of CT-guided interstitial implantation of 125I seeds for metastatic lung carcinoma. Methods A total of 82 patients with 126 metastatic lung tumors were treated with CT-guided percutaneous interstitial implantation of 125I seeds at a dose of 80 Gy. Six months after the treatment, the change of tumor volume was observed by using CT scan. The patients were followed up for 2 years. Results The mean radioactive dose was (159.3±34.5) Gy, and the median dose was (118.6±33.2) Gy. Six months after the treatment, CT scan showed a CR of 25.4% (32/126), PR 64.3% (81/126), NC 6.3% (8/126), PD 4.0% (5/126), and CR+PR 89.7% (113/126). Twelve patients showed pneumothorax and 41 had hemoptysis. During the follow-up, 11 patients (6 cases of malignant fibrous histiotoma, 3 cases of lung cancer, 1 rectal carcinoma, and 1 liver carcinoma) died within 8-12 months after the surgery. Fifteen patients (4 cases of malignant fibrous histiotoma, 4 lung cancer, 4 ovarian cancer, 2 multiple myeloma, and 1 uterine leiomyosarcoma) died within 13-24 months after the implantation. The 1-and 2-year survival rates were 86.6% (71/82) and 68.3% (56/82) respectively. Conclusion CT-guided percutaneous interstitial implantation of 125I seeds is effective for lung metastatic carcinoma.
【Key words】 Metastatic lung carcinoma; Radioactive 125I seeds; Implantation; CT;
- 【文献出处】 中国微创外科杂志 ,Chinese Journal of Minimally Invasive Surgery , 编辑部邮箱 ,2008年02期
- 【分类号】R734.2
- 【被引频次】17
- 【下载频次】209