放射性^(125)Ⅰ粒子源治疗中晚期肺癌的剂量学研究和临床观察  

Clinical Trial of Iodine-125 Seed Brachytherapy in Middle to Late Stage Lung Cancer

作　　者：何培坤[1] 张仲卫[1] 王桐[1] 李林[1] 高靖[1] 

机构地区：[1]天津市南开医院胸外科,天津市300100

出　　处：《中国肿瘤临床》2007年第20期1154-1156,共3页Chinese Journal of Clinical Oncology

基　　金：天津市自然科学基金资助(编号:043608111)

摘　　要：目的:观察放射性125Ⅰ粒子源治疗中晚期肺癌的疗效。方法:首先利用实体肿瘤等效材料,采用热释光剂量学方法,模拟实测了125I粒籽源植入瘤内后,瘤内外剂量分布,并对其剂量影响因素进行了详细研究;临床共对38例中晚期肺癌患者进行125I粒子种植,均采用电视胸腔镜辅助小切口下实施手术,进行临床观察。结果:根据实验研究结果确定125I粒子间距为1cm时能够达到治疗量(处方剂量145Gy);本组38例患者术后恢复顺利,手术后未发生出血、气胸、肺感染、肺不张等并发症。临床观察6个月,临床分析结果显示总缓解率为63.16%,咳嗽、气短、纳差、胸疼症状明显减轻,生活质量均有不同程度的改善(P<0.05)。结论:放射性125Ⅰ粒子源对于不能手术切除的中晚期肺癌是一种安全有效的治疗方法。Objective： To investigate the clinical efficacy of radioactive iodine-125 interstitial brachytherapy for treatment of middle to late stage lung cancer. Methods： The dose distribution of iodine-125 seeds was assessed by thermoluminescence dosimetry method （TLD） and dose calculation formula. The radial dose of iodine-125 seeds was compared using measured and calculated results. Thirty-eight patients with unresectable middle to late stage lung cancer were treated with interstitial radiation of iodine-125 seed implants. The iodine-125 seeds were implanted into the carcinoma by video adapter thoracoscope（VATS）. Results： The experimental results indicated that the effective interstitial space of the seeds was 1cm. After 6 months, the total response rate（CR＋PR） was 63.16%, and the symptoms of cough, shortness of breath, decreased appetite and chest pain were obviously reduced after surgery. There was no massive bleeding, pneumothorax, pneumonia or atelectasis after surgery. Conclusion： Radioactive iodine-125 seed implants are safe and effective and might be helpful in the treatment of unresectable middle to late stage lung cancer.

关 键 词：中晚期肺癌 ^125Ⅰ粒子源 永久性组织间植入 肿瘤近距离放疗 

分 类 号：R734.2[医药卫生—肿瘤]