摘要目的 评价CT导向下125I粒子植入肿瘤组织间治疗难治性肺癌的临床价值.方法 共35例晚期难治性肺癌患者接受125I粒子植入治疗.术前采用治疗计划系统计算布源,术中将活度为2.855～3.087 MBq的125I粒子在CT导向下植入肿瘤组织间,粒子按照0.5～1.0 cm间距平面插植.肿瘤周边匹配剂量为150～180 Gy,每例患者植入粒子10～120颗.2个月后行CT复查评价疗效.结果 完全缓解4例、部分缓解27例、稳定3例、进展1例,客观应答率为88.57%.术中和术后发生严重气胸5例,均经胸腔闭式引流3～10 d后完全消失;轻度气胸7例未行任何处理而自愈,经随访发现,大多数患者毒性反应轻微并可耐受,未见大咳血、放射性肺炎等严重并发症.结论 CT导向下125I粒子植入治疗晚期难治性肺癌的疗效确切,创伤小,并发症发生率低.

abstractsObjective To evaluate the clinical value of CT guided interstitial 125I seed implantation treatment of refractory lung cancer. Methods A total of 35 cases of refractory lung cancer patients underwent 125I seed implantation treatment. Preoperative treatment planning system was used to calculate the distribution of radioactive source, then 2.855-3.087 MBq 125I seeds were implanted into the tumor tissues intraoperatively. Plane implantation of the particles were made every 0.5-1.0 cm. Matched peripheral dose was 150-180 Gy, and 10-120 particles were implanted for each patient, who would be followed up by CT to explore their efficacies two months later. Results Of the 35 patients, there were complete remission 4 cases,partial remission 27 cases, stable disease 3 cases, and progressive disease 1 cases. The objective response rate was 88.57%. Serious intraoperative and postoperative pneumothorax occurred in 5 patients, among whom transference cure was found 3-10 days later after their closed thoracic drainage, and 7 mild pneumothorax patients healed without more treatment. After follow-up it was found that most toxic reactions were mild and tolerable, and no severe complications were reported like hemoptysis or radiation pneumonia. Conclusion It is effective, less inasie and of low complication rate in CT guided interstitial 125I seed implantation treatment of advanced refractory lung cancer.