【摘要】 目的:探讨CT引导下经皮穿刺植入125Ⅰ放射性粒子近距离治疗不能外科手术的早期非小细胞肺癌(non-small celllung cancer,NSCLC)的临床疗效。方法:选取2003年1月至2012年12月在天津医科大学第二医院接受治疗的经病理学明确诊断的早期NSCLC患者48例,其中Ⅰ期患者18例,Ⅱ期(N0)患者30例,对患者行CT引导下放射性125Ⅰ粒子植入治疗,术后6个月复查胸部CT,与粒子植入前进行比较,按照国际标准判定疗效。随访截至2013年12月。结果:全部患者顺利完成粒子植入治疗,靶区瘤体MPD(127.3±15.6)Gy,D100(113.1±17.2)Gy,D90(148.6±19.4)Gy,D90>MPD。术后6个月查胸部CT判定疗效,Ⅰ期患者中CR27.8%(5/18),PR 72.2%(13/18),SD、PD为0;Ⅱ期患者中CR 10%(3/30例),PR 73.3%(22/30例),SD 13.3%(4/30),PD 3.3%(1/30)。有效率(CR+PR)为Ⅰ期100%,Ⅱ期83.3%,总有效率89.6%。随访期内全部患者1年局控率85%,1年生存率95.8%(46/48),2年生存率81.3%(39/48),5年生存率56.3%(27/48)。结论:对于不能外科手术的早期非小细胞肺癌,进行CT引导下125Ⅰ放射性粒子植入治疗,是一种微创有效的治疗方法。更多还原

【Abstract】 Objective: To evaluate the curative effect of computed tomography(CT)-guided percutaneous implantation of125 I radioactive seeds on inoperable early-stage non-small cell lung cancer(NSCLC). Methods: From January 2003 to December 2012, we selected 48 patients who had pathologically confirmed early-stage NSCLC(stageⅠ, 18 cases; stageⅡ, 30 cases with N0). We treated the nidus by CT-guided percutaneous implantation of125 I radioactive seeds. Six months after implantation, the chest CT-scan was reviewed, and the effect of the treatment was evaluated according to the international standards. Final follow-up was performed in December 2013. Results: All operations were successfully completed. The target tumor matched peripheral doses(MPDs) were 215.8±14.3 Gy(D100), 106.8±11.6 Gy(D90), and 148.6±17.3 Gy(D90>MPD). Six months after implantation, chest CT was reviewed, and treatment effects were evaluated. The percentages of stage I patients achieving complete relief(CR), partial relief(PR), stable disease(SD), and progressive disease(PD) were 27.8%(5 cases), 72.2%(13 cases), 0%, and 0%, respectively. Among stage Ⅱpatients, CR, PR, SD, and PD percentages were 0%(3 cases), 73.3%(22 cases), 13.3%(4 cases), and 3.3%(1 case), respectively. The effective rate was 89.6%. The 1-year local control rate was 85%. Until December 2013, the1-, 2-, and 5-year cumulative survival rates up to the end of the interval were 95.8%(46/48), 81.3%(39/48), and 56.3%(27/48), respectively.Conclusion: CT-guided percutaneous implantation of125 I radioactive seeds is an effective micro-invasive method for treating inoperable early-stage NSCLC.更多还原