论文部分内容阅读
目的探讨CT引导下~(125)I放射性粒子植入治疗中晚期肺癌的近期疗效。方法 32例肺癌患者均经穿刺活检病理确诊,治疗前根据肿瘤大小利用放射性粒子治疗计划系统计算出治疗肿瘤所需的~(125)I粒子的最佳数量,然后经CT引导下经皮穿刺将~(125)I粒子均匀置入到肿瘤内进行组织间放疗,术后1、3、6个月分别进行随访做CT检查,根据肿瘤大小变化将疗效分为:(1)完全缓解(CR):肿瘤完全消失,影像学检查不能显示肿瘤或仅有条索状影像。(2)部分缓解(PR):肿瘤缩小≥50％。(3)无变化(SD):肿瘤缩小<50％或增大<25％。(4)进展(PD):肿瘤增大≥25％或出现新病灶。结果 1个月:CR 1例,PR 10例,SD 19例,PD 2例;3个月:CR 6例,PR 17例,SD 5例,PD 4例,总有效率 71.8％;6个月;CR 8例,PR 18例,SD例,PD 5例,总有效率 81.2％。25例(78.1％)术中穿刺过程中有少量渗血,19例(59.4％)出现不同程度气胸.肺压缩均在30％内,1例在3个月复查时发现胸壁原来穿刺的部位有癌灶种植。结论中晚期的肺癌患者给予~(125)I放射性粒子植入治疗,具有安全可靠、并发症少、微创、近期疗效显著、治疗时间短和重复治疗方法等优点。如能配合化疗或其他方法治疗,有望进一步提高治疗。
Objective To investigate the short-term curative effect of CT-guided 125I radioactive seed implantation in the treatment of advanced lung cancer. Methods Thirty-two patients with lung cancer were diagnosed by biopsy. According to the tumor size, the optimal number of ~ (125) I particles needed for tumor treatment was calculated according to the size of tumor using radioactive particle therapy planning system. Then the percutaneous puncture ~ (125) I particles were evenly placed in the tumor for interstitial radiotherapy. The patients were followed up for CT examination at 1, 3 and 6 months after operation. According to the tumor size, the curative effect was divided into: (1) complete remission : The tumor completely disappeared, imaging examination can not show tumor or only cord-like image. (2) partial remission (PR): tumor shrinkage ≥ 50%. (3) No change (SD): Tumor shrinkage <50% or increase <25%. (4) Progress (PD): tumor growth ≥25% or new lesions. Results 1 month: 1 case of CR, 10 cases of PR, 19 cases of SD and 2 cases of PD; 3 months: CR 6 cases, PR 17 cases, SD 5 cases and PD 4 cases, the total effective rate was 71.8%; 6 months ; CR 8 cases, PR 18 cases, SD cases, PD 5 cases, the total effective rate was 81.2%. Twenty-five patients (78.1%) had a small amount of bleeding during the procedure, 19 (59.4%) had different degrees of pneumothorax, and the lung compression was within 30%. One case was found at the 3-month follow- Foci implantation. Conclusions The treatment of ~ (125) I radioactive seed implantation in patients with advanced stage lung cancer is safe, reliable, with few complications, minimally invasive, significant curative effect in the near future, short treatment time and repeated treatment. If combined with chemotherapy or other methods of treatment, is expected to further improve treatment.