Peters Nils, Wieners Gero, Pech Maciej, Hengst Susanne, Rühl Ricarda, Streitparth Florian, Lopez Hänninen Enrique, Felix Roland, Wust Peter, Ricke Jens
Department of Radiology and Nuclear Medicine, Otto von Guericke University, Leipziger Strasse 44, Magdeburg, Germany.
Strahlenther Onkol. 2008 Jun;184(6):296-301. doi: 10.1007/s00066-008-1718-5.
CT-guided interstitial brachytherapy of primary lung malignancies and pulmonary metastases represents a novel interventional technique, combining conventional high-dose-rate (HDR) iridium-192 ((192)Ir) brachytherapy with modern CT guidance for applicator positioning and computer-aided 3-D radiation treatment planning. The purpose of this study was to assess safety and efficacy of this technique.
30 patients with 83 primary or secondary lung malignancies were recruited in a prospective nonrandomized trial (Table 1). After catheter positioning under CT fluoroscopy, a spiral CT was acquired for treatment planning (Figure 1). All but two patients received a defined single dose (coverage > 99%) of at least 20 Gy from a (192)Ir source in HDR technique.
Adverse effects were nausea (n = 3, 6%), minor (n = 6, 12%) and one major pneumothorax (2%). Post intervention, no changes of vital capacity and forced expiratory volume could be detected. The median follow-up period was 9 months (1-21 months) with a local tumor control of 91% at 12 months (Figure 2).
CT-guided interstitial brachytherapy proved to be safe and effective for the treatment of primary and secondary lung malignancies.
CT引导下原发性肺癌及肺转移瘤的间质近距离放射治疗是一种新型介入技术，它将传统的高剂量率（HDR）铱-192（192Ir）近距离放射治疗与现代CT引导的施源器定位及计算机辅助三维放射治疗计划相结合。本研究的目的是评估该技术的安全性和有效性。
在一项前瞻性非随机试验中纳入了30例患有83处原发性或继发性肺恶性肿瘤的患者（表1）。在CT透视引导下放置导管后，进行螺旋CT扫描以制定治疗计划（图1）。除两名患者外，所有患者均采用HDR技术从192Ir源接受了至少20 Gy的确定单剂量照射（覆盖范围>99%）。
不良反应包括恶心（n = 3，6%）、轻度不良反应（n = 6，12%）以及1例严重气胸（2%）。干预后，未检测到肺活量和用力呼气量的变化。中位随访期为9个月（1 - 21个月），12个月时局部肿瘤控制率为91%（图2）。
CT引导下间质近距离放射治疗被证明对原发性和继发性肺恶性肿瘤的治疗是安全有效的。
