放射性粒子植入治疗纵隔肿瘤

Radioactive seed implantation for mediastinal tumors

目的探讨纵隔内或纵隔旁恶性肿瘤放射性粒子瘤内植入治疗的方法及疗效。方法回顾性分析22例在CT引导下纵隔内及纵隔旁恶性肿瘤患者施行放射性粒子瘤内植入治疗的方法及疗效。结果 22例纵隔内及纵隔旁恶性肿瘤患者全部按预定计划完成了粒子植入。术后5例气胸,未做特殊处理自行吸收,无大出血等严重并发症。随访2～24个月复查CT显示肿块均有不同程度的缩小,其中7例肿块基本消失,仅残留少量聚集在一起的粒子影,9例肿块缩小50%以上,3例肿块缩小不足50%,3例缩小不明显;4例见有粒子分布不均匀,2例见粒子分布稀疏区肿块增大。结论放射性粒子瘤内植入治疗纵隔内或纵隔旁恶性肿瘤安全,微创,全身毒副作用小,能明显改善局部症状,近期疗效满意。

Objective To investigate the methods and results of radioactive particles implantation in malignant tumors in mediastinum or adjacent to mediastinum. Methods： A retrospective analysis of data of 22 cases was done, who underwent radioactive seed implantation in malignant tumors in mediastinum or adjacent to mediastinum under the CT guidance. Results： 22 cases completed scheduled implantation, in which 5 cases with postoperative pneumothorax, self-absorbed without special treatment, no bleeding or other serious complications. CT follow-up 2-24 months later showed mass reduced at different degrees. Tumor disappeared in 7 patients, with only residual particles. Tumor size reduced more than 50% in 9 cases , less than 50% in 3 cases, no reduction in 3cases. Uniform particle distribution was observed in 4 cases, and mass increased in particle sparse area in 2 cases. Conclusion： The implantation of radioactive particles in tumor adjacent to mediastinum or in mediastinum is safe, minimally invasive with less systemic toxic side effects. It can significantly control local symptoms, the recent results are satisfactory.