CAJ | 학술논문

目的评价CT引导125I放射性粒子植入(CTRISI)治疗其他原发恶性肿瘤肺转移的临床疗效及其影响因素.方法接受125I放射性粒子植入治疗其他脏器肿瘤肺转移的患者50例,其中,45例(90％)CTRISI单独治疗,5例手术与CTRISI联合治疗.评价5年局部控制率、5年生存率及影响生存率的因素.结果覆盖90％靶体积时的剂量(D90％)为(112.3±12.2)Gy,90％剂量覆盖的靶体积百分比(V90)为91.3％±8.2％,术后验证匹配周边剂量(MPD)为106.2 Gy.1、2、3、4、5年局部控制率分别为95.8％、86.5％、56.6％、42.4％、31.1％.中位随访期为26个月.中位生存期为27.1个月,1、2、3、4、5年生存率分别为83.4％、52.3％、38.7％、20.3％、13.7％.病灶直径≤4 cm或＞4 cm是预测总生存率(x2=4.621,P＜0.05)和无进展生存率(x2=7.548,P＜0.05)重要相关因素.结论对其他脏器原发肿瘤肺转移且无法完全切除的患者,CTRISI或联合手术切除是一种有效的治疗方法.
목적 평개CT인도125I방사성입자식입(CTRISI)치료기타원발악성종류폐전이적림상료효급기영향인소.방법 접수125I방사성입자식입치료기타장기종류폐전이적환자50례,기중,45례(90％)CTRISI단독치료,5례수술여CTRISI연합치료.평개5년국부공제솔、5년생존솔급영향생존솔적인소.결과 복개90％파체적시적제량(D90％)위(112.3±12.2)Gy,90％제량복개적파체적백분비(V90)위91.3％±8.2％,술후험증필배주변제량(MPD)위106.2 Gy.1、2、3、4、5년국부공제솔분별위95.8％、86.5％、56.6％、42.4％、31.1％.중위수방기위26개월.중위생존기위27.1개월,1、2、3、4、5년생존솔분별위83.4％、52.3％、38.7％、20.3％、13.7％.병조직경≤4 cm혹＞4 cm시예측총생존솔(x2=4.621,P＜0.05)화무진전생존솔(x2=7.548,P＜0.05)중요상관인소.결론 대기타장기원발종류폐전이차무법완전절제적환자,CTRISI혹연합수술절제시일충유효적치료방법.
Objective To evaluate the clinical outcomes and the prognostic factors in patients with pulmonary metastases treated with CT-guided radioactive 125I seed implantation(CTRISI).Methods A total of 50 patients were treated with implantation of 125I radioactive seeds under computed tomography (CT)guidance or combined with surgical resection.There were 10(20％)patients with colorectal cancer,8(16％)patients with malignant fibrous histiocytoma,5(10％)patients with sarcoma,22 (44％)patients with other cancer,respectively.CTRISI was the only treatment in 45 patients(90％)and combined with surgical resection in 5(10％).The local control rate,the survival rate and the factor associated with overall survival were evaluated.Results The D90％ was(112.3 ± 12.2)Gy,the V90 was 91.3％ ± 8.2％,and the postoperative matched peripheral dose(MPD)was 106.2 Gy.The local control rate for 1-,2-,3-,4-,5-year were 95.8％,86.5％,56.6％,42.4％,31.1％,respectively.At a mean follow-up of 26 months(7-74 months),6 patients were alive.The median survival time was 27.1 months.The survival rate for 1-,2-,3-,4-,5-year were 83.4％,52.3％,38.7％,20.3％,13.7％,respectively.Lesion size ≤ 4 cm or ＞ 4 cm was an important prognostic factor associated with overall survival(x2=4.621,P＜0.05)and disease-free survival(x2=7.548,P＜0.05).Conclusions CTRISI is safe in these patients with pulmonary metastases,with promising results.Surgical resection remains the standard for resectable patients,while CTRISI alone or combined with surgery might offer an alternative in selected patients.