中华放射医学与防护杂志

杨景魁,霍小东,闫卫亮,等.CT引导¹²⁵I粒子植入治疗恶性肿瘤肺转移的临床研究[J].中华放射医学与防护杂志,2013,33(5):505-507.YANG Jing-kui,HUO Xiao-dong,YAN Wei-liang,et al.CT-guided ¹²⁵I seed implantation in the treatment of malignant pulmonary metastases[J].Chin J Radiol Med Prot,2013,33(5):505-507

CT引导¹²⁵I粒子植入治疗恶性肿瘤肺转移的临床研究

CT-guided ¹²⁵I seed implantation in the treatment of malignant pulmonary metastases

投稿时间：2012-12-29

DOI：10.3760/cma.j.issn.0254-5098.2013.05.012

中文关键词: 肺转移瘤放射性¹²⁵I粒子外科手术切除

英文关键词:Pulmonary metastases Radioactive ¹²⁵I seeds Surgical resection

基金项目:

作者	单位	E-mail
杨景魁	300211 天津医科大学第二医院胸外科
霍小东	300211 天津医科大学第二医院胸外科	xxwtj@sina.com
闫卫亮	300211 天津医科大学第二医院胸外科
郑广钧	300211 天津医科大学第二医院胸外科
柴树德	300211 天津医科大学第二医院胸外科
孟娜	北京大学第三医院肿瘤治疗中心放疗科
杨瑞杰	北京大学第三医院肿瘤治疗中心放疗科
王俊杰	北京大学第三医院肿瘤治疗中心放疗科

摘要点击次数: 5275

全文下载次数: 2698

中文摘要:

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(D_90%)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(χ²=4.621,P<0.05)和无进展生存率(χ²=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。

英文摘要:

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 D_90% 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(χ²=4.621,P<0.05) and disease-free survival(χ²=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.

HTML 查看全文查看/发表评论下载PDF阅读器

关闭