Wang Meng, Shi Feng, Zhou Zhigang, Cui Yao, Du Kepu, Li Shuai, Liu Tingting, Chen Yanlin, Li Yadan, Gao Fei
Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Department of Interventional Treatment, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China.
J Contemp Brachytherapy. 2022 Feb;14(1):35-42. doi: 10.5114/jcb.2022.113548. Epub 2022 Feb 18.
The aim of this study was to explore the feasibility and clinical value of computed tomography (CT)-guided trans-sternal puncture to implant I seeds to treat masses in the anterior or middle mediastinum.
From September 2017 to December 2019, twenty patients with masses in the anterior or middle mediastinum were enrolled and treated with CT-guided trans-sternal I seeds implantation. Dosimetry parameters were compared between post-operative and pre-operative plans. Satisfaction rate of I seed distribution, complications, and local efficacy were evaluated.
A total of 22 lesions were treated with I implantation in twenty patients, all procedures being successfully completed. The dosimetry parameters of the 20 patients immediately after surgery were as follows: mean D = 134.30 ±14.53 Gy; mean V, V, V, and V were 96.10 ±1.55%, 92.69 ±1.93%, 66.86 ±7.53%, and 42.95 ±9.11%, respectively; mean conformity index (CI), external index (EI), and homogeneity index (HI) were 0.65 ±0.06, 40.79 ±13.72%, and 27.90 ±7.53%, respectively. The satisfaction rate of I seed distribution was 90%. The mean follow-up duration was 12 ±4.75 months (range, 4-24 months). The local control rates of 2 months, 6 months, and 1 year after surgery were 65.0%, 64.7%, and 53.8%, respectively. One patient had a small degree of pneumothorax, and one had hemoptysis after surgery.
CT-guided trans-sternal puncture plant I seeds for the treatment of masses in the anterior or middle mediastinum might serve as an alternative approach for treating specific mediastinal metastatic tumors.
本研究旨在探讨计算机断层扫描（CT）引导下经胸骨穿刺植入碘-125粒子治疗前纵隔或中纵隔肿块的可行性及临床价值。
2017年9月至2019年12月，纳入20例前纵隔或中纵隔肿块患者，接受CT引导下经胸骨碘-125粒子植入治疗。比较术后与术前计划的剂量学参数。评估碘-125粒子分布满意率、并发症及局部疗效。
20例患者共22个病灶接受碘-125粒子植入治疗，所有操作均成功完成。20例患者术后即刻剂量学参数如下：平均D=134.30±14.53Gy；平均V100、V90、V80和V50分别为96.10±1.55%、92.69±1.93%、66.86±7.53%和42.95±9.11%；平均适形指数（CI）、外扩指数（EI）和均匀性指数（HI）分别为0.65±0.06、40.79±13.72%和27.90±7.53%。碘-125粒子分布满意率为90%。平均随访时间为12±4.75个月（范围4 - 24个月）。术后2个月、6个月和1年的局部控制率分别为65.0%、64.7%和53.8%。1例患者术后出现轻度气胸，1例术后出现咯血。
CT引导下经胸骨穿刺植入碘-125粒子治疗前纵隔或中纵隔肿块可作为治疗特定纵隔转移瘤的一种替代方法。
