【作者】 付改发； 雷光焰； 白新宽； 赵竹莲； 宋养荣； 赵学武；

【Author】 Fu Gai-fa Lei Guang-yan Bai Xin-kuan Zhao Zu-lian Song Yang-rong Zhao Xue-wu (Department of chest surgery,Center of seed treatment,Tumor hospital of shannxi province,xi’an,china,710061)

【机构】 陕西省肿瘤医院胸外科粒子治疗中心；

【摘要】 目的:探讨用微创穿刺技术永久性植入¹²⁵Ⅰ粒子在Ⅲ、Ⅳ期肺癌综合治疗中的应用价值和临床疗效。方法:对29例中晚期肺癌（中心型10例）经常规治疗或其它疗法难以控制和部分初治病人,应用 TPS 计算剂量和制定布粒计划,在 CT 引导下经皮穿刺、单针分次植入¹²⁵Ⅰ粒子进行近距离放疗．植粒后 CT 检查布粒情况和有无并发症．3～7天内同步或分期进行化疗与其它疗法治疗．每3～4周采用胸片、 CT、MRI 观察肿瘤缩小效果。结果:粒子分布满意率86．2%（25/29）;近期总有效率89．7%（26/29）,其中 CR 27．6%（8/29）、PR62．1%（18/29）、NC 10．3%（3/29）,止痛有效率85．7%（12/14）;并发轻度出血10例（34．5%）, 其中肺内渗血6例（20．7%）、咯血4例（13．8%）。少量气胸2例（6．9%）,粒子移位1例（3．5%）。全组未发生白细胞降低和放射性肺炎。结论:微创植粒创伤小、并发症轻、安全有效,有着临床推广和实用价值。更多还原

【Abstract】 OBJECTIVE:Using radioactivity¹²⁵I seed permanent implants with micropuncture technique in lung cancer with Ⅲor Ⅳ stage,to study the value and effect of this method.METHODS:29 middle-late stage lung cancer patients（10 center lung cancer） who couldn’t get better by routine methods were treatment by ¹²⁵I seed permanent micropuncture implants brachytherapy.The dose and distribution of seeds was decided by TPS before treatment,and CT was used during implant treatment.Distribution of seeds and complication was review by CT after treatment.Chemotherapy was performed in 3～7days after implanting.The effect was observed by X-ray,CT and MRI.RESULTS:The satisfaction rate of seed distribution was 86.2%（25/29）;Total effective rate in a short time was 89.7%（26/29）:CR27.6%（8/29）;PR62.1%（18/29）;NC 10.3（3/29）.Effective rate of relieve pain was 85.7%（12/14）.10 cases had complication of mild bleeding:6 cases had bleeding in lung （20.7%）;4 cases Coughed up blood.2 cases had mild pneumothorax and 1 case had a malposition seed.There hadn’t one case whose leucocyte was low,and radiation pneumonia hadn’t occurred. CONCLUSION:It is a micro-wound,mild complication,safety and effective method that ¹²⁵I seed micropuncture implants.This method has many clinical values and was worth spread.更多还原