【作者】 刘瑞宝； 崔亚利； 马建群； 陈国珍； 隋林；

【Author】 Liu Rui-Bao Cui Ya-Li Ma Jian-Qun Pan Xue-Ling Yue Tong-Yun Chen Guo-Zhen Cui Lin The tumor hospital of Harbin medical university, Harbin, 150081

【机构】 哈尔滨医科大学附属肿瘤医院介入科；

【摘要】 目的:探讨125Ⅰ粒子植入治疗不可切除性肺癌的价值。方法:本组35例病人,男26人,女9人,年龄62—85 岁平均76岁。均由胸外科医生判定不可切除性肺癌。病人不愿意接受外放疗或化疗。其中,中心型肺癌9例,周围型肺癌18例,肺转移瘤8例。应用light speed 16CT,扫描层厚为5mm。肿瘤组织内分别植入活度为0．5-0．8的125Ⅰ粒子 (125Ⅰ粒子由宁波君安药业公司提供),穿刺针由Doctor Japan 生产。应用TPS(深圳和佳公司生产)系统确定粒子分布的剂量。依据病变的部位分别采用仰卧、俯卧或侧位等不同体位行CT扫描,确定穿刺入路。CT引导下穿刺。使125I粒子在肿瘤内均匀分布。结果:34例患者全部按TPS系统制定的计划完成治疗,1例治疗过程中出现严重气胸,经局部穿刺抽吸后肺组织没有膨张而中止治疗,8个月后实施二次治疗。35 例患者共植入125Ⅰ粒子1132粒,平均32．3粒。术后粒子经呼吸道咳出1例,治疗后1个月1例患者出现脑转移死亡。CT 复查显示所有病灶均缩小。5例病变消失。结论:125Ⅰ粒子植入只需一次性植入即可达到治疗目的。克服了化疗造成的毒副反应。同时克服了体外放疗时间长,存在间隔,治疗不连续的缺点。是治疗不可切除性肺癌的有效方法。更多还原

【Abstract】 Objective: To investigate the value of CT guiding 125Ⅰ seed implantation in patient with unresectbal lung cancer. Methods: 35 patients with unresectbal lung cancer experienced CT guiding 125Ⅰ seed implantation. 26 male, and 9 female, and age from 62 to 85.Neither of them can bear operation, nor of them accept chemotherapy or radiation.9 of them are central tumor 18 of them are peripheral lung cancer and 8 are metastatic node in lungs. The doses were decided according to TPS. CT guiding puncture was performed under Light speed 16spiral CT in different position according to the site of the tumor. The doses were decided according to TPS. CT guiding puncture was performed under 16 Light speed spiral CT in different position according to the site of the tumor. 125Ⅰ seeds were implant evenly in tumor according to TPS. Results: 34 of the 35 patients had complied the treatment according to TPS, one operation terminated for severe pneumothorax during treatment, and have a secondary treatment 8 months later. 1132 125Ⅰseeds were used for the 35 patients, average 32.3 per patient. One pa- tient died of cephalic metastases. one month after the treatment. Follow up CT show that all the patient except the died one have a desire result. The all the tumors become small and disappear for 5 patients one month later. Conclusion: CT guiding 125Ⅰ seed implantation is a safe less invasive and practical method in patient with unresectable lung cancer更多还原