CT引导^(125)I粒子植入术治疗非小细胞肺癌

CT guided ^(125)I seeds implantation in treatment of non-small cell lung cancer

目的探讨CT引导下125I粒子植入术治疗非小细胞肺癌(NSCLC)的临床应用价值。方法对24例NSCLC患者,采用治疗计划系统计算布源,在CT引导下将125I粒子植入瘤灶内。术后1个月复查胸部CT、血常规及血清肿瘤标记物,此后每3个月复查脑部和肺部CT,每6个月行全身骨扫描复查,随访12个月观察局部病灶控制情况及并发症。结果肺部目标病灶完全缓解6例(6/24,25.00%),部分缓解18例(18/24,75.00%)。术后发生少量气胸4例,痰中带血4例,发热5例,给予对症治疗后1～3天症状消失。术后1个月1例患者出现白细胞轻度下降,所有患者血清肺癌相关肿瘤标记物水平均不同程度好转。随访期内1例患者发生对侧肺转移,2例出现骨转移,1例脑转移,无死亡患者。结论 CT引导下125I粒子植入术治疗NSCLC创伤小、疗效显著、并发症少,是肺癌综合治疗的重要手段。

Objective To explore the clinical application value of CT guided ^125I seeds implantation in the treatment of non-small cell lung cancer （NSCLC）. Methods Twenty-four patients with pathologically confirmed NSCLC were treated with ^125I seeds implantation under CT guidance according to treatment planning system. Chest CT, blood routine and serum tumor markers were examined 1 month after implantation. Then chest and head CT were performed every 3 months and bone scans every 6 months. The patients were followed up for 12 months, and the effectiveness and complications were evaluated. Results The complete remission rate was 25.00% （6/24）, and the partial remission rate was 75.00%（18/24） among these target lesions in lung. Four patients had mild pneumothorax, 4 had sputum mixed with blood and 5 had fever after implantation, all were cured after 1-3 days symptomatic treatment. White blood cell count mildly decreased in 1 pa- tient, while the levels of serum tumor markers reduced in all the patients 1 month after implantation. Opposite lung metas- tases and brain metastases were found in 1 patient, respectively, and bone metastases in 2 patients. During the 12 months＂ following-up, 24 patients were all alive. Conclusion CT guided seed ^125I implantation is an important technique in comprehensive treatment of NSCLC with the advantages of less injury, significant effect and fewer complications. It can re- markably increase the survival rate of patients with NSCLC.