摘要
目的探讨cT引导下经皮穿刺植入^125I放射性粒子治疗老年Ⅰ期周围型非小细胞肺癌（NSCLC）的临床疗效、可行性及安全性。方法16例老年周围型肺癌患者中鳞癌10例、腺癌6例，ⅠA期13例、ⅠB期3例。15例为初治患者，均不宜或不愿手术及外放疗；1例先行外放疗无效。术前通过放射性粒子治疗计划系统制定治疗计划，处方剂量140～160Gy。CT引导下经皮穿刺将^125I粒子植入到肿瘤内。结果平均每例植入21．1颗粒子，完全缓解12例，部分缓解4例，有效率为100％。随访10～56个月，随访率100％，随访满1、2、3、4年者分别为15、13、8、6例。局部控制时间中位数为14个月。1、2、3、4年生存率分别为60％、54％、50％、33％，生存时间中位数为14个月。7例死于非肿瘤因素，5例死于肿瘤广泛转移。粒子植入过程中和以后均未发现严重并发症。结论CT引导下经皮植入^125I粒子疗效确切、安全性高，可作为不适合或不愿手术或放疗的老年Ⅰ期周围型NSCLC的根治性治疗方法。
Objective To evaluate the efficacy, feasibility and safety of CT guided percutaneous 1251 seeds implantation in elderly patients of stage Ⅰ peripheral non-small cell lung cancer （ NSCLC ）. Methods Clinical data of 16 elderly peripheral stage I NSCLC patients （ 10 squamous carcinoma and 6 adenocareinoma;13 stage ⅠA and 3 stage ⅠB） who received radioactive ^125I seeds implantation because of refusal or being unsuited to operation or external radiotherapy were retrospectively analyzed. Prescribed dose was 140 -160 Gy. Under CT guidance, ^125I seeds were implanted pereutaneously into tumors for interstitial radiotherapy according to treatment plan system. Results Mean number of ^125I seeds each patient received was 21.1. 12 complete response （CR） and 4 partial response （PR） were achieved. Total response rate （CR ＋ PR） was 100%. 100% patients completed 10 to 56 months of follow-up, 15, 13, 8 and 6 patients completed 1-, 2-, 3-and 4-years＇follow-up, respectively. The median local progression free time was 14 months. The 1-, 2-, 3-and 4-year overall survival rate were 60%, 54%, 50% and 33%, respectively （median： 14 months）. 7 cases died of non-tumor disease and 5 died of metastasis. No severe complications were observed. Conclusions CT guided ^125I seeds implantation is a safe, reliable and effective radical treatment method for elderly stage I peripheral NSCLC patients, who refuse to or are unsuitable to operation or external radiotherapy.
出处
《中华放射肿瘤学杂志》
CSCD
北大核心
2011年第5期394-396,共3页
Chinese Journal of Radiation Oncology
