CAJ | 학술논문

目的探讨CT引导下经皮穿刺植入125Ⅰ放射性粒子治疗老年Ⅰ期周围型非小细胞肺癌(NSCLC)的临床疗效、可行性及安全性。方法 16例老年周围型肺癌患者中鳞癌10例、腺癌6例,ⅠA期13例、ⅠB期3例。15例为初治患者,均不宜或不愿手术及外放疗;l例先行外放疗无效。术前通过放射性粒子治疗计划系统制定治疗计划,处方剂量140～ 160 Gy。CT引导下经皮穿刺将125Ⅰ粒子植入到肿瘤内。结果平均每例植入21.1颗粒子,完全缓解12例,部分缓解4例,有效率为100％。随访10～56个月,随访率100％,随访满l、2、3、4年者分别为15、13、8、6例。局部控制时间中位数为14个月。l、2、3、4年生存率分别为60％、54％、50％、33％,生存时间中位数为14个月。7例死于非肿瘤因素,5例死于肿瘤广泛转移。粒子植入过程中和以后均未发现严重并发症。结论 CT引导下经皮植入125Ⅰ粒子疗效确切、安全性高,可作为不适合或不愿手术或放疗的老年Ⅰ期周围型NSCLC的根治性治疗方法。
목적 탐토CT인도하경피천자식입125Ⅰ방사성입자치료노년Ⅰ기주위형비소세포폐암(NSCLC)적림상료효、가행성급안전성。방법 16례노년주위형폐암환자중린암10례、선암6례,ⅠA기13례、ⅠB기3례。15례위초치환자,균불의혹불원수술급외방료;l례선행외방료무효。술전통과방사성입자치료계화계통제정치료계화,처방제량140～ 160 Gy。CT인도하경피천자장125Ⅰ입자식입도종류내。결과 평균매례식입21.1과입자,완전완해12례,부분완해4례,유효솔위100％。수방10～56개월,수방솔100％,수방만l、2、3、4년자분별위15、13、8、6례。국부공제시간중위수위14개월。l、2、3、4년생존솔분별위60％、54％、50％、33％,생존시간중위수위14개월。7례사우비종류인소,5례사우종류엄범전이。입자식입과정중화이후균미발현엄중병발증。결론 CT인도하경피식입125Ⅰ입자료효학절、안전성고,가작위불괄합혹불원수술혹방료적노년Ⅰ기주위형NSCLC적근치성치료방법。
Objective To evaluate the efficacy, feasibility and safety of CT guided percutaneous 125Ⅰ seeds implantation in elderly patients of stage Ⅰ peripheral non-small cell lung cancer ( NSCLC ).Methods Clinical data of 16 elderly peripheral stage Ⅰ NSCLC patients ( 10 squamous carcinoma and 6adenocarcinoma;13 stage ⅠA and 3 stage ⅠB ) who received radioactive 125Ⅰ seeds implantation because of refusal or being unsuited to operation or external radiotherapy were retrospectively analyzed. Prescribed dose was 140 - 160 Gy. Under CT guidance, 125Ⅰ seeds were implanted percutaneously into tumors for interstitial radiotherapy according to treatment plan system. Results Mean number of 125Ⅰ seeds each patient received was21.1. 12 complete response (CR) and 4 partial response (PR) were achieved. Total response rate ( CR + PR) was 100％. 100％ patients completed 10 to 56 months of follow-up, 15, 13, 8 and 6 patients completed 1-, 2-, 3-and 4-years'follow-up, respectively. The median local progression free time was 14months. The 1-,2-,3-and 4-year overall survival rate were 60％, 54％, 50％ and 33％, respectively (median:14 months). 7 cases died of non-tumor disease and 5 died of metastasis. No severe complications were observed. Conclusions CT guided 125Ⅰ seeds implantation is a safe, reliable and effective radical treatment method for elderly stage Ⅰ peripheral NSCLC patients, who refuse to or are unsuitable to operation or external radiotherapy.