The Department of Radiology, First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou 350005, China; The Department of Radiology, Second Affiliated Hospital of Fujian Medical University, 34 Zhongshan Bei Road, Quanzhou 362000, China.
Eur J Radiol. 2013 Nov;82(11):2061-6. doi: 10.1016/j.ejrad.2013.05.037. Epub 2013 Jul 2.
To evaluate the feasibility and efficacy of percutaneous interstitial brachytherapy using iodine-125 ((125)I) radioactive seeds under computed tomographic (CT) guidance for malignant thoracic tumors.
Forty-one patients (34 males, 7 females; 18-90 years; mean, 63.7 years) with 77 lesions (3 in the mediastinum, 7 in the chest wall, 67 in the lung) underwent percutaneous interstitial implantation of (125)I radioactive seeds under CT guidance. A treatment planning system (TPS) was employed to calculate the number and distribution of seeds preoperatively. An 18-G needle was inserted into the lesions under CT guidance and send the seeds according to TPS. Two patients with mediastinal lesions undergoing seed implantation received an artificial pneumothorax. One patient with lung carcinoma adjacent to the anterior mediastinum underwent seed implantation through the sternum. Follow-up CT was done every 2 months postoperatively.
The procedure was successful in all patients. No major procedure-associated death occurred. The mean duration of follow-up was 19.4 ± 1.3 months (3-49 months). A complete response (CR) was seen in 49 lesions (63.6%), partial response (PR) in 9 lesions (11.7%), stable disease (SD) in 12 lesions (12.8%), and progressive disease (PD) in 7 lesions (7.4%). The overall response rate (CR+PR) was 75.3%; the local control rate (CR+PR+SD) was 90.9%. The 1-, 2- and 3-year progression-free rates for local tumors were 91%, 88% and 88%, respectively. The 1-, 2- and 3-year survival rates were 87%, 74% and 68%, respectively.
Implantation of CT-guided (125)I seeds is feasible and effective for patients with malignant thoracic tumors.
评估在计算机断层扫描（CT）引导下经皮间质近距离放射治疗碘-125（I-125）放射性粒子治疗胸部恶性肿瘤的可行性和疗效。
41 名患者（34 名男性，7 名女性；年龄 18-90 岁；平均年龄 63.7 岁）共 77 个病灶（纵隔 3 个，胸壁 7 个，肺 67 个）接受 CT 引导下经皮间质植入 I-125 放射性粒子治疗。术前采用治疗计划系统（TPS）计算粒子的数量和分布。在 CT 引导下，将 18-G 针插入病灶，并根据 TPS 发送种子。2 例纵隔病变患者接受人工气胸。1 例肺癌紧邻前纵隔，经胸骨植入种子。术后每 2 个月行 CT 随访。
所有患者均手术成功，无重大手术相关死亡。平均随访时间为 19.4±1.3 个月（3-49 个月）。49 个病灶（63.6%）完全缓解（CR），9 个病灶（11.7%）部分缓解（PR），12 个病灶（12.8%）稳定（SD），7 个病灶（7.4%）进展（PD）。总有效率（CR+PR）为 75.3%；局部控制率（CR+PR+SD）为 90.9%。局部肿瘤的 1、2、3 年无进展生存率分别为 91%、88%和 88%。1、2、3 年生存率分别为 87%、74%和 68%。
CT 引导下 I-125 种子植入治疗胸部恶性肿瘤是可行和有效的。
