摘要
目的价CT导向下经皮穿刺125I粒子组织间植入治疗肺转移癌的临床应用价值。方法 22例肺转移癌患者,其中肝癌肺转移10例11个病灶,乳腺癌肺转移5例7个病灶,前列腺癌肺转移7例9个病灶,共27个病灶。病灶平均直径为4.1cm,采用和佳HGGR-2000放射性粒子治疗计划计算布源,经CT导向下将125I粒子植入肿瘤病灶内。结果 22例27个病灶,术后随访6个月,完全缓解8/27,部分缓解9/27,无变化5/27,进展5/27,总有效率62.9%;术中6例出现肺内少量渗出,3例出现气胸,肺压缩均体积均在30%以内,经保守治疗好转,术后1周痰中带血5例;术后2～3周4例出现轻度白细胞下降,白细胞计数3～4*109/L,术后2个月的影像学检查发现肺内粒子游走2例,余未见其他严重并发症。结论 CT导向下经皮穿刺125I粒子组织间植入技术是治疗肺转移癌的有效方法,具有对原发病灶的治疗影响小、微创、辐照安全性大,近期效果好等优点,其长期的临床效果需要进一步临床研究。
Objective To investigate and discuss the clinical outcome of CT-guided radioactive seed 125I implantation in the treatment of metastatic lung tumors.Methods Twenty-two patients were recorded,including liver cancer 10 cases,breast carcinoma 5 cases,and prostatic cancer 7 cases.Radioactive 125I seeds were placed according to HGGR-2000 TPS system under CT guidance.Results Eight cases obtained CR,9 cases PR,5 cases NC,and 5 cases PD.The response rate was 62.9 %.The side effects occurred during the procedure including effusion in 6 cases,pneumothorax in 3 cases with lung compression less than 30%.Bloody sputum was found in 5 cases 1 week after the procedure.WBC decreased slightly in 4 cases 2-3 weeks after the procedure,but WBC count was 3～4＊109/L and seeds migration in 2 cases during 2 months follow up.There were no severe complications.Conclusions CT-guided radioactive seed 125I implantation is an effective technique in the treatment of metastatic lung tumors with the feature including low disturbance of the treatment of primary lesions,micro invasive,lower radiation doses,excellent short-term effects.The long-term effects are worthy of further clinical research.
出处
《当代医学》
2010年第29期567-570,共4页
Contemporary Medicine
关键词
肺肿瘤
转移性肿瘤
碘
CT
介入治疗
Lung tumors
metastatic tumors
Iodine-125
CT
Interventional therapy
