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计算机断层扫描引导下¹²⁵I放射性粒子植入治疗晚期肺癌所致恶性气道压迫:40例患者的有效性和安全性

Computed tomography-guided implantation of I radioactive seeds in patients with malignant airway compression induced by advanced lung cancer: effectiveness and safety in 40 patients.

作者信息

Zhao Zhiyou, Yao Wang, Zhang Tao, Chen Shixin, Fu Wei, Chen Lijun, Ma Yonggang, Wang Jianzhuang, Lu Mingjian, Jiao Dechao

机构信息

Department of Medical Imaging, 3201 Hospital of Xi'an Jiaotong University Health Science Center, Hanzhong, P.R. China.

Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, P.R. China.

出版信息

J Contemp Brachytherapy. 2020 Aug;12(4):343-350. doi: 10.5114/jcb.2020.98113. Epub 2020 Aug 21.

Abstract

PURPOSE

To evaluate the safety and efficacy of computed tomography (CT)-guided I radioactive seed implantation in patients with malignant airway compression induced by advanced lung cancer.

MATERIAL AND METHODS

Between June 2015 and June 2018, 40 patients from three medical institutions with malignant airway compression induced by advanced lung cancer were treated with I seed implantation. The outcomes were measured in technical success and safety, objective response rate, complications, Karnofsky performance status (KPS) score, and survival time.

RESULTS

All 40 patients successfully underwent implantation procedure. No procedure-associated death occurred. The most common complications were irritable cough, temporary hemoptysis, chest pain, fever, and pneumothorax, which occurred in 26 (65.0%), 31 (77.5%), 12 (30.0%), 15 (37.5%), and 11 (27.5%) patients, respectively. The objective response rates were 100%, 100%, 100%, 87.5%, and 83.3% at the 3, 6, 12, 24, and 36 months post-procedure, respectively. The KPS score significantly improved at post-procedure. Median survival time was 25.1 months. Actuarial survival rates were 100%, 60%, and 15% at the 12, 24, and 36 months after the procedure, respectively.

CONCLUSIONS

For patients with malignant airway compression induced by advanced lung cancer, implantation with I seed is a safe and effective alternative treatment option.

摘要

目的

评估计算机断层扫描(CT)引导下碘放射性粒子植入治疗晚期肺癌所致恶性气道压迫患者的安全性和有效性。

材料与方法

2015年6月至2018年6月,来自三家医疗机构的40例晚期肺癌所致恶性气道压迫患者接受了碘粒子植入治疗。评估指标包括技术成功率、安全性、客观缓解率、并发症、卡氏功能状态(KPS)评分和生存时间。

结果

40例患者均成功完成植入手术。未发生与手术相关的死亡。最常见的并发症为刺激性咳嗽、暂时性咯血、胸痛、发热和气胸,分别发生在26例(65.0%)、31例(77.5%)、12例(30.0%)、15例(37.5%)和11例(27.5%)患者中。术后3、6、12、24和36个月时的客观缓解率分别为100%、100%、100%、87.5%和83.3%。术后KPS评分显著改善。中位生存时间为25.1个月。术后12、24和36个月时的精算生存率分别为100%、60%和15%。

结论

对于晚期肺癌所致恶性气道压迫患者,碘粒子植入是一种安全有效的替代治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a509/7690234/84e0c0317c42/JCB-12-41565-g001.jpg

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