CT导引下经皮穿刺组织间植入^(125)I放射微粒子治疗中心型肺癌的应用研究

The study of curing central-type lung cancer by CT guided percutaneous embedding of ^(125)I seeds(

目的 探讨CT导引下经皮穿刺组织间植入12 5I放射微粒子治疗中心型肺癌的操作方法、安全性及疗效。方法 回顾分析 2 2例经CT平扫及增强扫描确诊的中心型肺癌 ,18例治疗前行CT导引下经皮穿刺活检快速病理证实 ,待病理结果后即刻行CT导引下经皮穿刺组织间植入12 5I放射微粒子 7～ 16粒 ,12 5I微粒子放射性活度为 2 2、2 6、30、33MBq/粒 ,植入微粒子放射性总活度为181～ 35 5MBq。穿刺点均为 1处 ,调整进针方向 2～ 5次 ,前胸壁入路 8例 ,侧胸壁入路 8例 ,后胸壁入路 6例。 2 2例中 6例行经静脉化疗 1～ 3次。结果 2 2例中随访满 1个月以上者 2 0例 ,2个月以上者 16例 ,3个月以上者 10例 ,6个月者 3例。 1个月随访 2 0例中 ,肿瘤直径缩小≥ 5 0 %者 18例 ,无变化 2例 ,增大 0例 ;2个月随访 16例中 ,肿瘤直径缩小≥ 5 0 %者 15例 ,无变化 1例 ,增大 0例 ;3个月随访 10例中 ,肿瘤直径缩小≥ 5 0 %者 8例 ,无变化 1例 ,增大 1例 ;6个月随访 3例中 ,肿瘤直径缩小≥ 5 0 %者 3例 ,无变化 0例 ,增大 0例。 2 2例中治疗前有明显肺段、肺叶不张 12例 ,随访中重新膨胀9例。治疗后新发生纵隔淋巴结转移 4例 ,新发生胸骨转移 1例、肝转移 1例。并发症 :气胸 11例 ,粒子脱落 1例。结论 经皮穿刺组织间植入12 5I放?

Objective To discuss the method, safety, and effect of curing central-type lung cancer by CT guided percutaneous embedding of ^(125)I among tissue . Methods Twenty-two cases of central-type lung cancer proved by CT scan were analyzed. 18 cases of them were proved by pathology before CT guided therapy. The therapy was conducted immediately after the pathology result was acquired. The number of ^(125)I particle was 7-16. The radioactivity quantum were 22, 26, 30, and 33 MBq per granule. The overall radioactivity quantum were 181-355 MBq. The number of puncture point was only one. The number of puncture direction was 2-5 times. Results 20 cases were followed up for 1 month, 16 cases for (2 months,) 10 cases for 3 months, and 3 cases for 6 months. In the 20 cases followed for 1 month, the diameter of the cancer reduced≥50% in 18 cases, no change in 2 cases, and enlarged in (0 case.) In the 16 cases followed for 2 months, the diameter reduced≥50% in 15 cases, no change in 1 case, and enlarged in 0 case. In the 10 cases followed for 3 months, the diameter reduced≥50% in 8 cases, no change in 1 case, and enlarged in 0 case. In the 3 cases followed for 6 months, the diameter all reduced≥50%. Atelectasis occurred in (12 cases) before therapy, the lung expanded again in 9 of them after therapy. The complications included pneumothorax in 11 cases and the brushing off of the particle in 1 case.Conclusion The cubage of the cancer could be reduced obviously after the therapy of CT guided percutaneous embedding of ^(125)I among tissue . It is an accurate and safe procedure, and it is effective for curing brushfire metastasis.