Li Jie, Zhang Lijuan, Xu Wenhuan, Wang Teng, Zhou Leyuan, Xie Qigen, Wang Weiguo, Hua Yanyan
Department of Interventional Radiology, The Affiliated Hospital of Jiangnan University (Wuxi 4 People's Hospital), Jiangsu Province.
Authors contributed equally to this work.
J Contemp Brachytherapy. 2017 Apr;9(2):132-138. doi: 10.5114/jcb.2017.67023. Epub 2017 Apr 3.
To retrospectively evaluate the efficacy and safety of computed tomography (CT)-guided percutaneous interstitial brachytherapy using I radioactive seeds for multiple pulmonary metastatic tumors.
Between September 2013 and December 2015, 22 patients with multiple pulmonary metastases, who after conventional chemotherapy and trans-arterial chemoembolization (TACE) therapy were considered unable to withstand stereotactic body radiation therapy (SBRT), received CT-guided I brachytherapy. Clinical data were studied retrospectively. A planning target volume of 90% (D) was 120-160 Gy for I seeds with an activity of 25.9 MBq. A CT-based evaluation performed 1, 2, and 6 months' post-implantation enabled review of local control of tumors.
Twenty-two patients with 65 pulmonary metastases successfully completed treatment. The mean value for D for implantation for I seeds was 132 Gy. Complete response (CR) + partial response (PR) was documented in 81.54%, 78.46%, and 78.46% of patients at 1, 2, and 6 months after implantation, respectively. Fourteen out of 22 patients had CR, 3 had PR, 2 had stable disease (SD), and 3 had progressive disease (PD). Most of the metastases (CR + PR + SD; 87.69% after 6 months) were controlled by implantation.
CT-guided I brachytherapy is a safe and effective treatment for multiple pulmonary metastatic tumors, and can achieve good short-term local control, so long as the radiation dose is sufficient.
回顾性评估计算机断层扫描（CT）引导下使用碘放射性粒子对多发性肺转移瘤进行经皮间质近距离放射治疗的疗效和安全性。
2013年9月至2015年12月期间，22例多发性肺转移患者在接受传统化疗和经动脉化疗栓塞（TACE）治疗后被认为无法耐受立体定向体部放射治疗（SBRT），接受了CT引导下的碘近距离放射治疗。对临床资料进行回顾性研究。对于活度为25.9MBq的碘粒子，计划靶体积的90%（D）为120 - 160Gy。在植入后1、2和6个月进行基于CT的评估，以复查肿瘤的局部控制情况。
22例有65个肺转移灶的患者成功完成治疗。碘粒子植入的D平均值为132Gy。植入后1、2和6个月时，分别有81.54%、78.46%和78.46%的患者出现完全缓解（CR）+部分缓解（PR）。22例患者中，14例CR，3例PR，2例疾病稳定（SD），3例疾病进展（PD）。大多数转移灶（CR + PR + SD；6个月后为87.69%）通过植入得到控制。
CT引导下的碘近距离放射治疗是治疗多发性肺转移瘤的一种安全有效的方法，只要放射剂量足够，就能实现良好的短期局部控制。
