【摘要】 【目的】纵隔转移淋巴结治疗比较困难。本研究评价CT导向下¹²⁵I粒子植入治疗晚期肿瘤纵隔转移淋巴结临床价值。【方法】回顾分析2003年11月至2008年4月间,中山大学肿瘤防治中心收治的15例经病理确诊为恶性肿瘤的患者,接受CT导向下¹²⁵I粒子植入治疗纵隔淋巴结的临床资料。转移淋巴结共计16个,直径1.0～4.0 cm;其中直径<2 cm 8个（50%）,2～3 cm 6个（37.5%）,>3,≤4 cm 2个（12.5%）。采用计算机立体定位计划系统计算布源,在CT导向下将（2.2～3.3）×107Mq活度的¹²⁵I粒子相隔1.0～1.5 cm平面播植。手术结束后2～3月复查CT。【结果】治疗前3例有疼痛症状患者中2例于术后5～14 d内疼痛缓解,有效率66.7%。15例患者中淋巴结完全缓解（CR）13例（86.7%）;部分缓解（PR）2例（13.3%）;总有效率100%。并发症为少量出血3例（20%）,少量气胸3例（20%）。【结论】CT导向下¹²⁵I粒子植入治疗纵隔转移淋巴结效果好,安全性高,创伤小,并发症发生率低。更多还原

【Abstract】 [Objective]Lymph node metastasis of mediastinum is difficult to treat.This study was to investigate the clinical value of CT-guided radioactive seed ¹²⁵I implantation in treating metastatic lymph node of interpleural space.[Methods]From November 2003 to April 2007,15 patients with pathologically confirmed malignant tumors received CT-guided radioactive seeds ¹²⁵I implantation to treat a total of 16 metastatic lymph nodes.The diameter of these metastatic lymph nodes ranged from 1.0 to 4.0 cm:8（50%） of them with diameter of<2.0 cm,6（37.5%） with diameter of 2.0～3.0 cm,2（12.5%） with diameter of 3.1～4.0 cm.Treatment planning system was used to design the distribution of seed ¹²⁵I.Under CT guidance,¹²⁵I seeds of（2.2-3.3）×10⁷ Mq were implanted into the metastatic lymph nodes at a distance of 1.0～1.5 cm.CT re-examination was performed at 2 or 3 months after seed ¹²⁵I implantation.[Results]Three patients had pain caused by metastatic lymph nodes and 2 of them had the pain relieved 5～14 days after the implantation,with a response rate of 66.7%.Of the 15 patients,13（86.7%） achieved complete remission（CR）,2（13.3%） achieved partial remission（PR）,the overall response rate was 100%.The major complication was slight hemorrhage developed in 3 patients（20%）,and small amount of pheumothorax developed in 3 patients（20%）. [Conclusion]CT-guided radioactive seed ¹²⁵I implantation is effective and safety in treating metastatic lymph node,with minimal damage and few complications.更多还原