【作者】 周琨； 吴沛宏； 张福君； 黄金华； 范卫君； 张亮； 刘健；

【Author】 Zhou Kun. , WU Pei-hong, ZHANG Fu-jun, Huang Jin-hua, FAN Wei-jun, ZHANG Liang. Deparment of General Surgery, the clinical medicine collage of Hebei University of Engineering, HanDan 056029, China

【机构】 河北工程学院临床医学院普外科； 中山大学肿瘤医院医学影像与介入中心；

【摘要】 目的评价胃肠道来源肺转移瘤CT导向下125I粒子植入治疗的短期疗效。方法20 例胃肠道来源帖转移瘤病人,男13例．女7例,年龄25-73岁。中位年龄为49±24岁。肺内病灶5个以下,大小0．5-3cm。20例病人病灶数56个．平均每人2．8个病灶．病灶平均直径2．1cm。其中单肺13例,双肺7例。原发病灶均有病理诊断,肺转移均经CT或MRI检查后临床诊断。利用计算机三维立体定向治疗计划系统(TPS)计算布源．在CT引导下将125I粒子植入肺转移病灶内。观察治疗后2个月病灶变化。结果20例56个病灶,完全缓解(CR)32个;部分缓解(PR) 19个;无变化(NC)5个。总有效率91．1％。2个月内无死亡病例。发生气胸2例。咯血痰2例, 胸腔出血1例,均经常规治疗后好转。结论胃肠道来源肺转移瘤,肺内病灶5个以下,最大直径不超过3cm,CT导向下125I粒子植入治疗,创伤小,并发症发生率低,近期效果好。更多还原

【Abstract】 objective To investigate the short term effect of CT guided radioactive seed 125I implantation in treating pulmonary metastases from gastrointestinal tumor. Methods 20 patients (male 13, female 7, the age rang of 25 to 73, mean age 49±24) with pulmonary, metastases from gastrointestinal tumor accepting CT guided radioactive seed 125I implantation were enrolled in this study. Among these patients, no more than 5 pulmonary metastases lesions in any case, and diameter of the lesions was from 0.5 to 3.0cm. Average 2.8 pulmonary metastases lesions per case, mean daimeter of pulmonary metastases lesion was 2.1cm. 13 cases were found pulmonary metastases lesions only in the one lang, 7 case were found pulmonary metastases lesions in the bilateral lung. All primary tumors were confirmed by pathology, and pulmonary metastases were confirmed hy CT or MRI and pathology. Under CT guidance, 125I seeds were implanted into pulmonary metastases according to CT based computerized, treatment planning in radio-oncology the treatment planning system (TPS). All Cases were observed two months after treament. Result Among 56 pulmonary metastases in 20 patients, 32 obtained CR, 19 PR, 5 NC. The responseive rate was .91.1%. During the observation, no death occurred, but pneumothorax in 2 cases, bloody sputum in 2 cases, hemothorax in 1 case. Conclusion CT guided radioactiv seed 125I implantation procedure has satisfying clinical effects in treating pulmonary metastases from gastrointestinal tumor with minimal damage and few complications, especially in these patients who had no more than 5 pulmonary metastases lesions, and, less than 3. 0cm in diameter.更多还原