CAJ | 학술논문

目的:研究CT引导下经皮穿刺植入放射性125I粒子治疗恶性纤维组织细胞瘤术后肺转移瘤的临床疗效.方法:选取自2006年1月至2011年8月在天津医科大学附属第二医院接受治疗的恶性纤维组织细胞瘤术后经病理明确诊断出现肺转移瘤的患者10例,对转移病灶行CT引导下经皮穿刺肿瘤内放射性125I粒子植入治疗.术后6个月复查胸部CT,与粒子植入前比较肿瘤变化,按照国际标准判定疗效.随访自2006年6月至2012年6月.结果:全部患者顺利完成粒子植入治疗,靶区接受的平均照射剂量为(207.4±43.1)Gy,D100(99.7±10.6)Gy,D90(127.5±16.1)Gy.植入术后6个月随访,有效率80.0%.截至2012年6月,10例患者中2例生存,8例死亡,死亡患者术后平均生存时间14.6±3.5个月,中位生存期13个月.术中6例患者出现气胸,其中3例行胸腔闭式引流术,3例行胸腔穿刺抽气;6例患者出现肺内针道出血,不伴咳血,无进行性血胸,止血处理后症状消失,1个月后复查出血吸收.结论:放射性粒子对于恶性纤维组织细胞瘤术后肺部转移病灶短期局部效果明显,可以作为一种有效的局部治疗手段.
목적:연구CT인도하경피천자식입방사성125I입자치료악성섬유조직세포류술후폐전이류적림상료효.방법:선취자2006년1월지2011년8월재천진의과대학부속제이의원접수치료적악성섬유조직세포류술후경병리명학진단출현폐전이류적환자10례,대전이병조행CT인도하경피천자종류내방사성125I입자식입치료.술후6개월복사흉부CT,여입자식입전비교종류변화,안조국제표준판정료효.수방자2006년6월지2012년6월.결과:전부환자순리완성입자식입치료,파구접수적평균조사제량위(207.4±43.1)Gy,D100(99.7±10.6)Gy,D90(127.5±16.1)Gy.식입술후6개월수방,유효솔80.0%.절지2012년6월,10례환자중2례생존,8례사망,사망환자술후평균생존시간14.6±3.5개월,중위생존기13개월.술중6례환자출현기흉,기중3례행흉강폐식인류술,3례행흉강천자추기;6례환자출현폐내침도출혈,불반해혈,무진행성혈흉,지혈처리후증상소실,1개월후복사출혈흡수.결론:방사성입자대우악성섬유조직세포류술후폐부전이병조단기국부효과명현,가이작위일충유효적국부치료수단.
@@@@Objective: To investigate the clinical efficacy of CT-guided percutaneous 125I radioactive seed implantation in treating postoperative lung metastases of malignant fibrous histiocytoma (MFH). Methods: From June 2006 to August 2011, 10 patients with pathologically confirmed lung metastases after MFH surgery received CT-guided percutaneous 125I radioactive seed implantation. After a six-month implantation, the chest CT scan was reviewed and the changes were evaluated according to international standards. The pa-tients were followed up from June 2006 to June 2012. Results: All operations were successfully completed. The average dose delivered to the nidus was (207.4±43.1) Gy, D100 (99.7±10.6)Gy, D90 (127.5±16.1) Gy. Two patients were alive and eight were dead until June 2012. Patient survival was 14.6 months ± 3.5 months, and the median survival time was 13 months. The overall response rate was 80.0%. Six pneumothorax cases in all operations were identified, three of which were treated by closed drainage of pleural cavity, and the remaining three by thoracocentesis (three cases). We administered hemostatic therapy to six cases of pulmonary hemorrhage. Con-clusion: CT-guided 125I radioactive seed implantation exhibits short-term clinical efficacy in treating postoperative lung metastases of MFH.