Wei Wei, Shen Xiao-hong, Sun Hui-hui, Lu Wen-li, Chai Shu-de, Yang Jing-kui
Medical School of Nankai University, Tianjin 300071, China. Email:
Zhonghua Nei Ke Za Zhi. 2012 Dec;51(12):978-81.
To explore influential factors of local therapeutic effect in CT guided brachytherapy of (125)I seeds for non-small-cell lung carcinoma (NSCLC).
Totally 141 primary NSCLC patients diagnosed by bronchoscope or puncture biopsy were treated with CT guided (125)I seeds implantation treatment from 2003 January to 2005 January. Among them, 26 patients were treated with seeds implantation only and remaining 115 combined with chemical therapy. Preplans were performed by using treatment planning system before the implantation. We took the implantation with the prescription dose of 80 - 110 Gy, 1 seed per 1 cm(3), under the guide of computed tomography. Six months after implantation treatment, CT graphs were taken to evaluate the therapeutic effect.
All the patients were survival until 6 months after implantation, and 37 were complete remission, 93 were partial remissions. The effective rate was 92.2%. Among all the observed factors, pathologic type(F = 5.162, P = 0.023), dose of cover 100% tumor (D(100)) (F = 100.713, P = 0.000) and treatment methods (F = 16.205, P = 0.000) were the independent influent factors (P < 0.05). Among these, D(100) was the most important factor (P = 0.000). Single factor analysis indicated that pathologic type (χ(2) = 7.313, P = 0.007), D(100) (χ(2) = 71.6, P = 0.000) and treatment methods (χ(2) = 20.5, P = 0.000) were significant influent factors. Of all 141 cases, 24 had complications during or after implantation treatment, while no severe complications were reported. There was no significant correlation between complication and local therapeutic effect (P > 0.05).
CT guided implantation of (125)I seeds for lung cancer has good clinical effects and few complications. D(100) is the most important factor to influence the local therapeutic effect. Implantation treatment combined with chemotherapy is an ideal measure for NSCLC treatment.
探讨CT引导下125I粒子植入治疗非小细胞肺癌（NSCLC）局部治疗效果的影响因素。
选取2003年1月至2005年1月期间经支气管镜或穿刺活检确诊的141例原发性NSCLC患者，行CT引导下125I粒子植入治疗。其中，单纯粒子植入治疗26例，其余115例联合化疗。植入前使用治疗计划系统进行预计划。在计算机断层扫描引导下，以80～110 Gy的处方剂量、每1 cm³植入1粒粒子进行植入。植入治疗6个月后，行CT扫描评估治疗效果。
所有患者植入后均存活至6个月，完全缓解37例，部分缓解93例。有效率为92.2%。在所有观察因素中，病理类型（F = 5.162，P = 0.023）、肿瘤100%覆盖剂量（D(100)）（F = 100.713，P = 0.000）和治疗方法（F = 16.205，P = 0.000）为独立影响因素（P < 0.05）。其中，D(100)是最重要的因素（P = 0.000）。单因素分析表明，病理类型（χ(2) = 7.313，P = 0.007）、D(100)（χ(2) = 71.6，P = 0.000）和治疗方法（χ(2) = 20.5，P = 0.000）是显著影响因素。141例患者中，24例在植入治疗期间或之后出现并发症，但未报告严重并发症。并发症与局部治疗效果之间无显著相关性（P > 0.05）。
CT引导下125I粒子植入治疗肺癌临床效果良好，并发症少。D(100)是影响局部治疗效果的最重要因素。植入治疗联合化疗是NSCLC治疗的理想措施。
