CT引导经皮肺穿刺肿瘤内化疗技术流程

Technical procedure of CT⁃guided intratumoral chemotherapy for lung tumor

肺癌在我国的发病率和死亡率均居所有肿瘤之首。目前,手术、化疗、放疗、靶向治疗、免疫治疗等局部与全身治疗是有效的治疗方法。近年,肿瘤内化疗的开展逐渐成为肿瘤治疗领域的焦点。利用超声、支气管镜、超声支气管镜、超声内窥镜或CT等影像学和介入方式进行肿瘤穿刺和给药。化疗药物如顺铂、卡铂、丝裂霉素、紫杉醇脂质体、氟尿嘧啶原液或稀释液通过穿刺针直接注入癌组织称为瘤内化疗。瘤内化疗可增加化疗药物在肿瘤组织中的浓度,降低药物的全身不良反应,提高肿瘤的局部控制率。深圳大学附属华南医院肿瘤科开展了肺癌、肝转移瘤、骨转移瘤瘤内化疗的临床应用与探索性研究,并观察了患者获益情况和初步疗效。本文总结了CT引导下经皮肺穿刺肿瘤内化疗的技术流程。

The incidence and mortality rates of lung cancer in China rank the first of all tumors.At present,there are many effective treatment methods,including surgery,chemotherapy,radiotherapy,targeted therapy,immunotherapy and other local and systematic treatments.In recent years,intratumoral chemotherapy,which combines the advantages of local therapy and systemic therapy,has gradually become the focus.By using ultrasound,bronchoscope,ultrasonic bronchoscope,endoscopic ultrasonography or CT and other imaging and interventional modalities,chemotherapeutics such as cisplatin,carboplatin,mitomycin,paclitaxel liposomes,fluorouracil in stock or diluted solutions are directly injected into the cancer tissue through the puncture needle.Intratumoral chemotherapy can increase the concentration of chemotherapeutics in the tumor tissue,reduce the systemic toxicity and side effects,and improve the local control rate of cancers.We have carried out clinical application and exploratory research on intratumoral chemotherapy for lung cancer,liver metastasis and bone metastasis,and observed patients’benefits and primary efficacy.This paper will sum⁃marize the technical procedure of CT⁃guided intratumoral chemotherapy.