立体定向近距离治疗宫颈癌肺转移灶初探  

A preliminary study on stereotactic ablative brachytherapy for lung metastases from cervical cancer

作　　者：刘颖[1] 周云[1,2] 谢小萱 任洪荣 李那[1] 惠慧 蒋威 LIU Ying;ZHOU Yun;XIE Xiaoxuan;REN Hongrong;LI Na;HUI Hui;JIANG Wei(Xuzhou Central Hospital,Xuzhou 221000 China;Xuzhou Clinical School of Xuzhou Medical University,Xuzhou 221000 China;Fengxian People’s Hospital,Xuzhou 221700 China)

机构地区：[1]徐州市中心医院,江苏徐州221000 [2]徐州医科大学徐州临床学院,江苏徐州221000 [3]徐州市丰县人民医院,江苏徐州221700

出　　处：《中国辐射卫生》2023年第5期569-572,585,共5页Chinese Journal of Radiological Health

基　　金：江苏省妇幼健康项目(F202035);徐州医科大学面上项目(XYFM2020013)。

摘　　要：目的初步探讨立体定向近距离消融治疗(stereotactic ablative brachytherapy,SABT)在宫颈癌肺转移患者治疗中的疗效和安全性。方法分析18例接受SABT的宫颈癌肺内转移患者的临床资料,比较SABT前后肿瘤区体积(volume of gross tumor,VGTV)、鳞状细胞癌抗原(squamous cell carcinomaantigen,SCC)、最终临床获益率(clinical benefit rate,CBR)变化,并记录其不良反应。结果经SABT治疗后,VGTV较治疗前明显减小(t=1.708,P<0.05),SCC较前下降(t=1.740,P<0.05);CBR高达94.44%。所有患者均未发生3~4级不良反应,14例患者出现轻微并发症,其中痰中带血1例,少量气胸1例。10例患者出现轻度的放射性肺损伤,其中4例达到二级放射性肺炎。相关因素分析表明,KPS评分及进针深度与不良反应发生无相关性,靶区半径及间质性肺病与不良反应发生相关。结论作为一种可选择的治疗方式,宫颈癌肺转移患者行SABT是安全、有效的。Objective To preliminarily study the effectiveness and safety of stereotactic ablative brachytherapy(SABT)for lung metastases from cervical cancer.Methods We analyzed the clinical data of 18 patients with cervical cancer with lung metastasis treated with SABT to compare gross tumor volume(VGTV)and squamous cell carcinoma(SCC)antigen before and after SABT.The clinical benefit rate(CBR)and adverse reactions were recorded.Results After SABT treatment,there were significant decreases in VGTV(t=1.708,P<0.05)and the SCC antigen level(t=1.704,P<0.05).CBR reached 94.4%.Adverse reactions of grades 3-4 did not occur in any patient.Fourteen patients had mild complications,including 1 case of bloody sputum and 1 case of a small pneumothorax.Ten cases developed mild radiation-induced lung injury,with grade 2 radiation pneumonitis in 4 cases.The Karnofsky performance status score and needle depth were not associated with the occurrence of adverse reactions,while the radius of GTV and interstitial lung disease were associated with the occurrence of adverse reactions.Conclusion SABT is a safe and effective alternative to the treatment of lung metastases from cervical cancer.

关 键 词：立体定向近距离消融治疗 肺转移癌 临床获益率 

分 类 号：R815.2[医药卫生—放射医学]