CAJ | 학술논문

目的初步探讨CT引导125I粒子植入治疗复发或转移胸壁肿瘤的可行性和疗效.方法回顾分析2004-2012年间23例复发或转移胸壁恶性肿瘤患者接受CT引导125 I粒子植入治疗资料.术前计算机治疗计划系统行三维治疗计划,确定粒子数目、空间分布,术后即刻CT扫描剂量验证.90％靶体积接受的剂量为100 ～ 160 Gy(中位数130 Gy),125I粒子活度为(1.85 ～2.89) ×107Bq(中位数2.63×107 Bq).植入粒子8～269颗(中位数53颗).局部控制率和生存率计算采用Kaplan-Meier法.结果随访率100％,随访时间满3、5年者分别为11、8例.23例患者中4例完全缓解、12例部分缓解.1、3、5年局部控制率分别为82％、62％、62％,肿瘤特异生存率分别为61％、45％、45％,总生存率分别为58％、58％、39％.疗后1例患者出现轻中度臂丛神经损伤,6例出现1、2级皮肤损伤.结论初步结果显示CT引导125I粒子植入治疗复发或转移胸壁肿瘤安全有效.
목적 초보탐토CT인도125I입자식입치료복발혹전이흉벽종류적가행성화료효.방법 회고분석2004-2012년간23례복발혹전이흉벽악성종류환자접수CT인도125 I입자식입치료자료.술전계산궤치료계화계통행삼유치료계화,학정입자수목、공간분포,술후즉각CT소묘제량험증.90％파체적접수적제량위100 ～ 160 Gy(중위수130 Gy),125I입자활도위(1.85 ～2.89) ×107Bq(중위수2.63×107 Bq).식입입자8～269과(중위수53과).국부공제솔화생존솔계산채용Kaplan-Meier법.결과 수방솔100％,수방시간만3、5년자분별위11、8례.23례환자중4례완전완해、12례부분완해.1、3、5년국부공제솔분별위82％、62％、62％,종류특이생존솔분별위61％、45％、45％,총생존솔분별위58％、58％、39％.료후1례환자출현경중도비총신경손상,6례출현1、2급피부손상.결론 초보결과현시CT인도125I입자식입치료복발혹전이흉벽종류안전유효.
Objective To preliminarily evaluate the feasibility and therapeutic effect of 125 I seed implantation under computed tomography (CT) guidance in the treatment of recurrent or metastatic chest wall tumor.Methods A retrospective analysis was performed on the clinical data of 23 patients with recurrent or metastatic malignant chest wall tumor who underwent 125I seed implantation under CT guidance from July 2004 to October 2012.A computerized treatment planning system was used for three-dimensional treatment planning before operation to determine the number and spatial distribution of 125I seeds.CT scan dosimetry was performed immediately after operation.The dose received by 90％ of the target volume was 100-160 Gy (median:130 Gy).The activity of 125I seeds was (1.85-2.89) × 107 Bq (median:2.63 × 107 Bq).The total number of seeds implanted was 8-269 (median:53).The local control rate and survival rate were calculated by the Kaplan-Meier method.Results The follow-up rate was 100％.Two patients were followed up for at least 3 years,and 2 for at least 5 years.Of the 23 patients,4 had a complete remission,and 12 had a partial remission.The 1-,3-,and 5-year local control rates were 82％,62％,and 62％,respectively; the 1-,3-,and 5-year tumor-specific survival rates were 61％,45％,and 45％,respectively;the 1-,3-,and 5-year overall survival rates were 58％,58％,and 39％,respectively.After treatment,mild or moderate brachial plexus injury was seen in one patient,and grade 1 or 2 skin injury was seen in 6 patients.Conclusions 125I seed implantation under CT guidance is safe and effective in the treatment of recurrent or metastatic chest wall tumor,according to the preliminary study.