Collettini F, Schnapauff D, Poellinger A, Denecke T, Banzer J, Golenia M J, Wust P, Gebauer B
Radiologie, Charité - Universitätsmedizin Berlin.
Rofo. 2012 Apr;184(4):316-23. doi: 10.1055/s-0031-1299101. Epub 2012 Feb 1.
To evaluate the safety and efficacy of CT-guided high-dose brachytherapy (CT-HDRBT) ablation of primary and metastatic lung tumors.
Between November 2007 and May 2010, all consecutive patients with primary or metastatic lung tumors, unsuitable for surgery, were treated with CT-HDRBT. Imaging follow-up after treatment was performed with contrast-enhanced CT at 6 weeks, 3 months and every 6 months after the procedure. The endpoints of the study were local tumor control and time to progression. The Kaplan-Meier method was used to estimate survival functions and local tumor progression rates.
34 procedures were carried out on 33 lesions in 22 patients. The mean diameter of the tumors was 33.3 mm (SD = 20.4). The first contrast-enhanced CT showed that complete ablation was achieved in all lesions. The mean minimal tumor enclosing dose was 18.9 Gy (SD = 2). Three patients developed a pneumothorax after the procedure. The mean follow-up time was 13.7 (3 - 29) months. 2 of 32 lesions (6.25 %) developed a local tumor progression. 8 patients (36.3 %) developed a distant tumor progression. After 17.7 months, 13 patients were alive and 9 patients had died.
CT-HDRBT ablation is a safe and attractive treatment option for patients with lung malignancies and allows targeted destruction of tumor tissue with simultaneous preservation of important lung structures. Furthermore, CT-HDRBT is independent of the size of the lesion and its location within the lung parenchyma.
评估CT引导下高剂量近距离放射治疗（CT-HDRBT）消融原发性和转移性肺肿瘤的安全性和有效性。
2007年11月至2010年5月，所有连续的不适于手术的原发性或转移性肺肿瘤患者均接受CT-HDRBT治疗。治疗后通过在术后6周、3个月以及每6个月进行的增强CT进行影像随访。研究的终点为局部肿瘤控制和疾病进展时间。采用Kaplan-Meier方法估计生存函数和局部肿瘤进展率。
对22例患者的33个病灶进行了34次治疗。肿瘤的平均直径为33.3mm（标准差=20.4）。首次增强CT显示所有病灶均实现完全消融。平均最小肿瘤包绕剂量为18.9Gy（标准差=2）。3例患者术后发生气胸。平均随访时间为13.7（3 - 29）个月。32个病灶中有2个（6.25%）出现局部肿瘤进展。8例患者（36.3%）出现远处肿瘤进展。17.7个月后，13例患者存活，9例患者死亡。
CT-HDRBT消融术对于肺恶性肿瘤患者是一种安全且有吸引力的治疗选择，能够在保留重要肺结构的同时对肿瘤组织进行靶向破坏。此外，CT-HDRBT与病灶大小及其在肺实质内的位置无关。
