CT引导125I粒子植入治疗恶性肿瘤肺转移的临床研究  

CT-guided nsI seed implantation in the treatment of malignant pulmonary metastases

作　　者：杨景魁[1] 霍小东[1] 闫卫亮[1] 郑广钧[1] 柴树德[1] 孟娜[2] 杨瑞杰[2] 王俊杰[2] 

机构地区：[1]天津医科大学第二医院胸外科,300211 [2]北京大学第三医院肿瘤治疗中心放疗科

出　　处：《中华放射医学与防护杂志》2013年第5期505-507,共3页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的 评价CT引导125I放射性粒子植入（CTRISI）治疗其他原发恶性肿瘤肺转移的临床疗效及其影响因素.方法 接受125I放射性粒子植入治疗其他脏器肿瘤肺转移的患者50例,其中,45例（90％）CTRISI单独治疗,5例手术与CTRISI联合治疗.评价5年局部控制率、5年生存率及影响生存率的因素.结果 覆盖90％靶体积时的剂量（D90％）为（112.3±12.2）Gy,90％剂量覆盖的靶体积百分比（V90）为91.3％±8.2％,术后验证匹配周边剂量（MPD）为106.2 Gy.1、2、3、4、5年局部控制率分别为95.8％、86.5％、56.6％、42.4％、31.1％.中位随访期为26个月.中位生存期为27.1个月,1、2、3、4、5年生存率分别为83.4％、52.3％、38.7％、20.3％、13.7％.病灶直径≤4 cm或＞4 cm是预测总生存率（x2=4.621,P＜0.05）和无进展生存率（x2=7.548,P＜0.05）重要相关因素.结论 对其他脏器原发肿瘤肺转移且无法完全切除的患者,CTRISI或联合手术切除是一种有效的治疗方法.Objective To evaluate the clinical outcomes and the prognostic factors in patients with pulmonary metastases treated with CT-guided radioactive 125I seed implantation（CTRISI）.Methods A total of 50 patients were treated with implantation of 125I radioactive seeds under computed tomography （CT）guidance or combined with surgical resection.There were 10（20%）patients with colorectal cancer,8（16%）patients with malignant fibrous histiocytoma,5（10%）patients with sarcoma,22 （44%）patients with other cancer,respectively.CTRISI was the only treatment in 45 patients（90%）and combined with surgical resection in 5（10%）.The local control rate,the survival rate and the factor associated with overall survival were evaluated.Results The D90% was（112.3 ± 12.2）Gy,the V90 was 91.3% ± 8.2%,and the postoperative matched peripheral dose（MPD）was 106.2 Gy.The local control rate for 1-,2-,3-,4-,5-year were 95.8%,86.5%,56.6%,42.4%,31.1%,respectively.At a mean follow-up of 26 months（7-74 months）,6 patients were alive.The median survival time was 27.1 months.The survival rate for 1-,2-,3-,4-,5-year were 83.4%,52.3%,38.7%,20.3%,13.7%,respectively.Lesion size ≤ 4 cm or 〉 4 cm was an important prognostic factor associated with overall survival（x2=4.621,P〈0.05）and disease-free survival（x2=7.548,P〈0.05）.Conclusions CTRISI is safe in these patients with pulmonary metastases,with promising results.Surgical resection remains the standard for resectable patients,while CTRISI alone or combined with surgery might offer an alternative in selected patients.

关 键 词：肺转移瘤 放射性125I粒子 外科手术切除 

分 类 号：R734.2[医药卫生—肿瘤]