CT引导下经皮穿刺种植放射性^(125)I粒子治疗晚期肺癌  

CT guided transcutaneous interstitial implantation of ^(125)I seeds for lung carcinoma

作　　者：柴树德[1] 郑广钧[1] 毛玉权[1] 杨景魁[1] 梁吉祥[1] 闫卫亮[1] 

机构地区：[1]天津医科大学第二医院胸心外科,300211

出　　处：《中华放射肿瘤学杂志》2004年第4期291-293,共3页Chinese Journal of Radiation Oncology

摘　　要：目的　探讨应用肿瘤组织间三维立体定向放射治疗计划系统 (TPS)、CT引导下经皮穿刺种植放射性12 5I粒子治疗晚期非小细胞肺癌及并发症处理方法。方法　随机选择 5 3例术前活检证实为非小细胞肺癌患者 ,应用TPS计算出放射源—12 5I粒子在瘤灶区的剂量分布 ,绘出等剂量曲线及适形粒子分布图并制定治疗计划 ,通过CT引导经皮穿刺种植12 5I粒子。术后即刻CT扫描验证 ,术后2个月复查CT检查肿瘤情况。结果　植入粒子后 ,瘤体接受的平均照射剂量为 15 0 .5Gy ,mPD84 .6Gy,D90 92 .4Gy,D90 >mPD。 2例需要立即补种粒子。术后 2个月复查的 37例患者 ,胸CT显示完全缓解 10例 ,部分缓解 2 7例。并发症包括术中气胸 19例 ,咳血 7例 ,术后发烧 5例 ,4例粒子移位 ,2例游走。结论　TPS立体定向CT引导下经皮穿刺种植放射性12 5I粒子是一种有效的。Objective To evaluate the technic,result and complications of interstitial implantation of 125 I seeds for NSCLC guided by CT aided with three dimensional treatment planning system (TPS). Methods Fifty-three NLCLC patients confirmed by puncture pathology were tratment with interstitial implantation of 125 I seeds guided by CT with TPS monitored immediately by CT after implantation.Another scanning of the tumor was repeated after 2months. Results The mean radioactive dose were 150.5?Gy,mPD 84.6?Gy,D 90 92.4?Gy,D 90 > mPD. Of 37 re-scanned patients,10 showed CR while 27 showed PR. Complications were pneumothorax 19,hemoptysis 7, fever 5,dislodge 4 and seeds moved 2. Conclusion CT guided transcutaneous interstitial implantation of 125 I seeds is valid and only minimally traumatic for NLCLC.

关 键 词：CT引导 经皮穿刺种植 放射性^125I粒子 治疗 肺癌 

分 类 号：R734.2[医药卫生—肿瘤]