^(125)I粒子植入联合化疗治疗中晚期非小细胞肺癌的临床研究  

Clinical Research of ^(125)I Seeds Implantation Combined with Chemotherapy in the Treatment of Middle-Late Stage Non-Small Cell Lung Cancer

作　　者：方勇[1] 倪旭东[1] 王健[2] 

机构地区：[1]复旦大学附属中山医院分部胸外科,上海200052 [2]复旦大学附属中山医院分部放疗科,上海200052

出　　处：《中国临床医学》2013年第2期132-134,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨125I粒子植入联合化疗治疗中晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的疗效。方法:2006年12月—2009年12月对38例中晚期NSCLC患者行放射性125I粒子植入联合化疗。术前根据三维治疗计划系统(treatmentplanning system,TPS)计算出模拟的放射性125I粒子的剂量分布和所需的125I粒子数及粒子活度,制定布粒计划,术中调整125I粒子的插植位置,术后再次CT扫描进行质量验证。125I粒子植入后3～7 d开始化疗,选用NP(长春瑞滨+顺铂)或TP(紫杉醇+顺铂)化疗方案。结果:84.2%(32/38)的患者中插植粒子的分布符合术前TPS作出的模拟剂量分布。全组共植入125I粒子1046颗,平均每个病灶27.5颗,无围手术期病死病例。所有患者平均随访16.3个月,完全缓解14例(36.8%),部分缓解21例(55.3%),稳定3例(7.9%),总有效率为92.1%。患者1年和2年生存率分别为81.2%(31/38)和66.7%(18/27)。全组无患者发生放射性肺炎、125I粒子脱靶易位或排出体外。结论:放射性125I粒子植入联合化疗治疗中晚期NSCLC安全、微创,并发症发生率低,疗效满意。Objective：To investigate the technological feasibility and efficacy of radioactive iodine 125 seeds implantation combined with chemotherapy in the treatment of middle-late stage NSCLC. Methods： A total of 38 patients with middle-late stage NSCLC were treated by 125I seeds implantation combined with chemotherapy during December 2006 to December 2009. Before the operation, the simulated dose distribution, the amount of iodine and the radiation activity were calculated by treatment planning system（TPS）. The seeds distribution plan was also established, and the implantation position was artificially modified during the operation. Quality assurance was performed by post-operational CT scan. Results： The distribution of implanted iodine in 82.4% patients （32/38） was in accordance with simulated dose distribution. A total of 1046 iodine was implanted in all patients with an average of 27.5 in each lesion. No death was reported in perioperative period. All patients have been followedup for an average period of 16.3 months. Among them, 14 patients （36. 8%） were in complete remission, 21 （55.3 %） cases were in partial remission, and 3 cases were stabilized （7.9 %）. The total effective rate was 92. 1 %. The survival rates at 1 year and 2 years were 81.2% （31/38） and 66.7 % （18/27）, respectively. Neither radiation pneumonia nor iodine miss translocation or elimination from the body occurred. Conclusions： 125I seeds implantation combined with chemotherapy have good efficacy with low complication rate in middle-late stage NSCLC patients.

关 键 词：非小细胞肺癌 125I粒子植入 化疗 

分 类 号：R734.2[医药卫生—肿瘤]