CAJ | 학술논문

目的评价CT引导下125I粒子植入治疗肺恶性肿瘤的临床价值.方法 40例肺部恶性肿瘤患者,其中22例为肺癌,共39个病灶；18例为肺转移瘤(原发癌11例为肝癌,5例为肠癌,2例为乳腺癌),共24个病灶.病灶平均直径为2.8 cm (1.0 ～6.3 cm).每个病灶植入粒子数目为7～45粒,中位粒子数27粒.粒子活度为29.6 MBq,粒子间距0.5 ～1.0 cm,肿瘤周边匹配剂量为(MPD) 120～ 140 Gy,观察局部控制率及并发症.结果 4 个月后评价,40例共63个病灶,完全缓解(CR)31个,部分缓解(PR) 21个；无变化(NC)8个,进展(PD)3个,总有效率(CR+ PR)为82.5％；术中患者均有肺内少量渗出,4例出现气胸,肺部压缩均在30％以内,经保守治疗后好转;术后1周内痰中带血19例；未行特殊处理自行缓解；术后2周内1例患者出现白细胞轻度下降,术后4个月影像学检查发现肺内粒子游走3例,未见其他严重并发症发生.结论放射性粒子植入治疗肺恶性肿瘤,近期效果好,是治疗肺部恶性肿瘤的简便、安全有效的方法.
목적 평개CT인도하125I입자식입치료폐악성종류적림상개치.방법 40례폐부악성종류환자,기중22례위폐암,공39개병조；18례위폐전이류(원발암11례위간암,5례위장암,2례위유선암),공24개병조.병조평균직경위2.8 cm (1.0 ～6.3 cm).매개병조식입입자수목위7～45립,중위입자수27립.입자활도위29.6 MBq,입자간거0.5 ～1.0 cm,종류주변필배제량위(MPD) 120～ 140 Gy,관찰국부공제솔급병발증.결과 4 개월후평개,40례공63개병조,완전완해(CR)31개,부분완해(PR) 21개；무변화(NC)8개,진전(PD)3개,총유효솔(CR+ PR)위82.5％；술중환자균유폐내소량삼출,4례출현기흉,폐부압축균재30％이내,경보수치료후호전;술후1주내담중대혈19례；미행특수처리자행완해；술후2주내1례환자출현백세포경도하강,술후4개월영상학검사발현폐내입자유주3례,미견기타엄중병발증발생.결론 방사성입자식입치료폐악성종류,근기효과호,시치료폐부악성종류적간편、안전유효적방법.
Objective To evaluate the clinical value of CT-guided radioactive seed 125I implantation on malignant lung tumors.Methods Forty patients(male 27,female 13,median age 51.0) with malignant lung tumors including 22 primary ones (39 foci) and 18 lung metastatic neplasm(24 foci of HCC in 11 cases,intestinal carcinoma in 5 cases,breast carcinoma in 2 case).The max diameter of each lesion ranges from 1.0 cm to 6.3 cm (median 2.8 cm).The number of 125I seed implanted per patient was 7-45 (median 27),the radioactive activity per seed was 29.6MBq and the Matched Peripheral Dose(MPD) was 90-160 Gy.The local control rate and clinical complications were observed.Results Among 63 lesions in 40 cases after 4 months follow-up,31 obtained CR,21 PR,8 NC,and 1 PD; with total response rate of 82.5％.The side effects occurred during the procedure including a few amount of effusion in all patients,pneumothorax in 4 cases with lung compression less than 30％,bloody sputum in 15 cases at 1 week after the procedure and seeds migration in 3 cases during 4 months follow up.WBC decreased slightly in 1 cases at 2 weeks after the procedure,without other severe complications.Conclusions CT-guided radioactive seed implantation is safe and well-tolarated in treating malignant lung tumors with few complications and good short term efficacy.