CAJ | 학술논문

目的评价CT导向下125I粒子植入肿瘤组织间治疗难治性肺癌的临床价值.方法共35例晚期难治性肺癌患者接受125I粒子植入治疗.术前采用治疗计划系统计算布源,术中将活度为2.855～3.087 MBq的125I粒子在CT导向下植入肿瘤组织间,粒子按照0.5～1.0 cm间距平面插植.肿瘤周边匹配剂量为150～180 Gy,每例患者植入粒子10～120颗.2个月后行CT复查评价疗效.结果完全缓解4例、部分缓解27例、稳定3例、进展1例,客观应答率为88.57%.术中和术后发生严重气胸5例,均经胸腔闭式引流3～10 d后完全消失;轻度气胸7例未行任何处理而自愈,经随访发现,大多数患者毒性反应轻微并可耐受,未见大咳血、放射性肺炎等严重并发症.结论 CT导向下125I粒子植入治疗晚期难治性肺癌的疗效确切,创伤小,并发症发生率低.
목적 평개CT도향하125I입자식입종류조직간치료난치성폐암적림상개치.방법 공35례만기난치성폐암환자접수125I입자식입치료.술전채용치료계화계통계산포원,술중장활도위2.855～3.087 MBq적125I입자재CT도향하식입종류조직간,입자안조0.5～1.0 cm간거평면삽식.종류주변필배제량위150～180 Gy,매례환자식입입자10～120과.2개월후행CT복사평개료효.결과 완전완해4례、부분완해27례、은정3례、진전1례,객관응답솔위88.57%.술중화술후발생엄중기흉5례,균경흉강폐식인류3～10 d후완전소실;경도기흉7례미행임하처리이자유,경수방발현,대다수환자독성반응경미병가내수,미견대해혈、방사성폐염등엄중병발증.결론 CT도향하125I입자식입치료만기난치성폐암적료효학절,창상소,병발증발생솔저.
Objective To evaluate the clinical value of CT guided interstitial 125I seed implantation treatment of refractory lung cancer. Methods A total of 35 cases of refractory lung cancer patients underwent 125I seed implantation treatment. Preoperative treatment planning system was used to calculate the distribution of radioactive source, then 2.855-3.087 MBq 125I seeds were implanted into the tumor tissues intraoperatively. Plane implantation of the particles were made every 0.5-1.0 cm. Matched peripheral dose was 150-180 Gy, and 10-120 particles were implanted for each patient, who would be followed up by CT to explore their efficacies two months later. Results Of the 35 patients, there were complete remission 4 cases,partial remission 27 cases, stable disease 3 cases, and progressive disease 1 cases. The objective response rate was 88.57%. Serious intraoperative and postoperative pneumothorax occurred in 5 patients, among whom transference cure was found 3-10 days later after their closed thoracic drainage, and 7 mild pneumothorax patients healed without more treatment. After follow-up it was found that most toxic reactions were mild and tolerable, and no severe complications were reported like hemoptysis or radiation pneumonia. Conclusion It is effective, less inasie and of low complication rate in CT guided interstitial 125I seed implantation treatment of advanced refractory lung cancer.