摘要目的:探讨局部复发非小细胞肺癌采用 192Ir近距离治疗的疗效和安全性。 方法:收集河北省沧州中西医结合医院自2013—2018年间调强放疗后局部复发的非小细胞肺癌22例。采用 192Ir高剂量率近距离治疗复发病灶，处方剂量30Gy1次，治疗后前3个月每1个月复查CT，3个月后每3个月复查CT，评价局控率、不良反应，复发治疗后1、2年总生存率。 结果:22例患者均顺利完成治疗，1、3、6个月病灶完全缓解率分别为9%、14%、14%，部分缓解率分别为82%、82%、82%，疾病稳定率分别为5%、0%、0%，疾病进展率分别为5%、5%、5%；有效率分别为91%、96%、96%。复发治疗后1、2年总生存率分别为59%、27%。急性放射性肺炎5例占23%(1级3例、2级2例)，骨髓抑制4例占18%(白细胞减少1级3例、血小板减少1级1例)，术后气胸1例，给予对症治疗后均好转。结论:192Ir近距离治疗局部复发非小细胞肺癌安全有效、不良反应可耐受。

abstractsObjective:To evaluate the clinical efficacy and adverse events of 192Ir high-dose rate brachytherapy (HDR-BT) in the treatment of locally recurrent non-small cell lung cancer (NSCLC). Methods:Clinical data of 22 cases of recurrent NSCLC after radiotherapy admitted to our hospital from September 2013 to March 2018 were retrospectively analyzed. 192Ir HDR-BT was adopted for reradiotherapy. The prescription dose was 30Gy for 1 fraction. CT scan was reviewed every 1 month in the first 3 months after treatment and every 3 months after 3 months. Local control rate and adverse events were evaluated. The 1-and 2-year overall survival (OS) rates of re-treatment after relapse were calculated. Results:All the 22 patients completed the treatment successfully. The 1-, 3-and 6-month complete response (CR) rates were 9%, 14% and 14%, 82%, 82% and 82% for the partial response (PR) rates, 5%, 0% and 0% for the stable disease (SD) rates, 5%, 5% and 5% for the progressive disease (PD) rates, 91%, 96% and 96% for the objective response rates (ORR), respectively. The 1-and 2-year OS rates of re-treatment after relapse were 59% and 27%. Five patients (23%) experienced acute radiation-induced pneumonitis (3 cases of grade 1 and 2 cases of grade Ⅱ), 4 cases (18%) of radiation-induced bone marrow suppression (3 cases of grade I leukopenia and 1 case of grade I thrombocytopenia) and 1 case of postoperative pneumothorax. All these adverse events were mitigated after symptomatic treatment.Conclusion:192Ir HDR-BT is an efficacious and safe treatment of locally recurrent NSCLC.