多排螺旋CT引导下经皮氩氦刀冷冻消融术结合植入^(125)I粒子治疗肺癌的近期疗效观察

MSCT-guided percutaneous cryoablation combined with ^(125)I-seed implantation for the treatment of lung cancer:an observation of short-term efficacy

目的探讨多排螺旋CT(MSCT)三维重建引导下经皮穿刺氩氦刀冷冻消融术结合植入125I粒子治疗肺癌近期疗效及安全性。方法 51例中晚期肺癌患者在MSCT三维重建引导下,氩氦刀冷冻消融治疗后,对瘤周及未冷冻区应用治疗计划系统(TPS)计算剂量和布粒,再行MSCT三维重建定位植入125I放射性粒子;1、2、3、6个月后全部行胸部CT平扫及增强复查。结果术后1、2、3、6个月随访,好转率分别为9.8%、19.6%、56.9%和46.0%;总有效率分别为31.4%、62.8%、98.0%和92.0%。结论 CT引导下经皮穿刺氩氦刀冷冻消融术结合植入125I粒子治疗肺癌安全、损伤小、并发症轻、近期疗效确切、值得推广。

Objective To evaluate the short-term efficacy of MSCT-guided percutaneous argonhelium cryoablation combined with ^125I-seed implantation in treating lung cancer,and to discuss the clinical feasibility and safety of this technique.Methods Under the guidance of MSCT 3D-reconstruction imaging,percutaneous argon-helium cryoablation was performed in 51 patients with advanced lung cancer,which was followed by ^125I-seed implantation with the help of treatment plan system（TPS）.The ^125I seeds were implanted into the edge and the un-frozen area of the tumor according to the therapeutic dosage and distribution calculated by TPS.After the procedure MSCT 3D-reconstruction imaging was carried out to check the location of the implanted ^125I seeds.Both plain and contrast-enhanced CT scans of the chest were conducted 1,2,3 and 6 months after the treatment.The therapeutic results were analyzed and evaluated.Results One,2,3 and 6 months after the treatment favorable improvement was seen in 9.8%,19.6%,56.9% and 46.0% of patients respectively,with the total effective rate of 31.4%,62.8%,98.0% and 92.0% respectively.Conclusion For the treatment of lung cancer MSCT-guided percutaneous puncture argon-helium cryoablation ablation combined with ^125I-seed implantation is a safe and minimally-invasive technique with fewer complications and reliable short-term effect.Therefore,it is of value to popularize this therapy in clinical practice.