杨景魁, 吕金爽, 阎卫亮, 郑广钧, 冯震, 霍小东. 放射性粒子植入治疗不能手术的早期非小细胞肺癌疗效分析[J]. 中国肿瘤临床, 2014, 41(17): 1111-1114. DOI: 10.3969/j.issn.1000-8179.20140487
引用本文: 杨景魁, 吕金爽, 阎卫亮, 郑广钧, 冯震, 霍小东. 放射性粒子植入治疗不能手术的早期非小细胞肺癌疗效分析[J]. 中国肿瘤临床, 2014, 41(17): 1111-1114. DOI: 10.3969/j.issn.1000-8179.20140487
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YANG Jingkui, LV Jinshuang, YAN Weiliang, ZHENG Guangjun, FENG Zhen, HUO Xiaodong. Analysis of curative effect of implantation of radioactive seeds on inoperable early-stage non-small cell lung cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2014, 41(17): 1111-1114. DOI: 10.3969/j.issn.1000-8179.20140487
Citation: YANG Jingkui, LV Jinshuang, YAN Weiliang, ZHENG Guangjun, FENG Zhen, HUO Xiaodong. Analysis of curative effect of implantation of radioactive seeds on inoperable early-stage non-small cell lung cancer[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2014, 41(17): 1111-1114. DOI: 10.3969/j.issn.1000-8179.20140487
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放射性粒子植入治疗不能手术的早期非小细胞肺癌疗效分析

Analysis of curative effect of implantation of radioactive seeds on inoperable early-stage non-small cell lung cancer

    摘要
  • 摘要:
      目的  探讨CT引导下经皮穿刺植入125Ⅰ放射性粒子近距离治疗不能外科手术的早期非小细胞肺癌（non-small cell lung cancer，NSCLC）的临床疗效。
      方法  选取2003年1月至2012年12月在天津医科大学第二医院接受治疗的经病理学明确诊断的早期NSCLC患者48例，其中Ⅰ期患者18例，Ⅱ期（N0）患者30例，对患者行CT引导下放射性125Ⅰ粒子植入治疗，术后6个月复查胸部CT，与粒子植入前进行比较，按照国际标准判定疗效。随访截至2013年12月。
      结果  全部患者顺利完成粒子植入治疗，靶区瘤体MPD（127.3±15.6）Gy，D100（113.1±17.2）Gy，D90（148.6±19.4）Gy，D90>MPD。术后6个月查胸部CT判定疗效，Ⅰ期患者中CR 27.8%（5/18），PR 72.2%（13/18），SD、PD为0；Ⅱ期患者中CR 10%（3/30例），PR 73.3%（22/30例），SD 13.3%（4/30），PD 3.3%（1/30）。有效率（CR+PR）为Ⅰ期100%，Ⅱ期83.3%，总有效率89.6%。随访期内全部患者1年局控率85%，1年生存率95.8%（46/48），2年生存率81.3%（39/48），5年生存率56.3%（27/48）。
      结论  对于不能外科手术的早期非小细胞肺癌，进行CT引导下125Ⅰ放射性粒子植入治疗，是一种微创有效的治疗方法。

     

    Abstract:
      Objective  To evaluate the curative effect of computed tomography (CT)-guided percutaneous implantation of 125Ⅰ radioactive seeds on inoperable early-stage non-small cell lung cancer (NSCLC).
      Methods   From January 2003 to December 2012, we selected 48 patients who had pathologically confirmed early-stage NSCLC (stageⅠ, 18 cases; stageⅡ, 30 cases with N0). We treated the nidus by CT-guided percutaneous implantation of 125Ⅰ radioactive seeds. Six months after implantation, the chest CT-scan was reviewed, and the effect of the treatment was evaluated according to the international standards. Final follow-up was performed in December 2013.
      Results  All operations were successfully completed. The target tumor matched peripheral doses (MPDs) were 215.8±14.3 Gy (D100), 106.8±11.6 Gy (D90), and 148.6± 17.3 Gy (D90 > MPD). Six months after implantation, chest CT was reviewed, and treatment effects were evaluated. The percentages of stage Ⅰ patients achieving complete relief (CR), partial relief (PR), stable disease (SD), and progressive disease (PD) were 27.8% (5 cases), 72.2% (13 cases), 0%, and 0%, respectively.Among stage Ⅱpatients, CR, PR, SD, and PD percentages were 0% (3 cases), 73.3% (22 cases), 13.3% (4 cases), and 3.3% (1 case), respectively. The effective rate was 89.6%. The 1-year local control rate was 85%. Until December 2013, the 1-, 2-, and 5-year cumulative survival rates up to the end of the interval were 95.8% (46/48), 81.3% (39/48), and 56.3% (27/48), respectively.
      Conclusion   CT-guided percutaneous implantation of 125Ⅰ radioactive seeds is an effective micro-invasive method for treating inoperable early-stage NSCLC.

     

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