Treatment of Central Type Lung Cancer by CT Guided Percutaneous Implants of ^125I Radioisotopes

摘要

OBJECTIVE To discuss the method, safety and effectiveness of the treatment for central-type carcinoma of the lungs by CT guided percutaneous implants of ^125I radioisotopes in tissues.METHODS Twenty-two cases of central-type lung cancer located by plain and/or enhanced CT scans were retrospectively analyzed, among which 18 cases were verified pathologically using a CT guided percutaneous puncture and biopsy before treatment. The CT guided treatment was conducted immediately after the pathological results were obtained. The number of the radioisotopes used was seven to 16. The intensities of radioactivity for ^125I radioisotopes were 22, 26, 30 and 33MBq per particle.The total intensity of radioactivity was 181 to 355 MBq. The puncture point was only one. The frequency for adjustment of needling direction was two to five times. The punctures were conducted through the anterior chest wall in eight cases, through the lateral chest wall in eight cases and thruogh the posterior chest wall in six cases. Six of the 22 cases were given intravenous chemotherapy.RESULTS Of the 22 cases, 20 were followed-up for more than one month, 16 over two months, ten over three months and three cases for six months. In the 20 cases which were followed-up for one month, the diameters of the tumors were reduced by 50.% or more in 18 cases, showed no change in two cases with none showing enlargement. In the 16 cases followed-up for more than two months, the diameters of tumors were reduced by 50% or more in 15 cases, one case showed no change and none enlarged. In the ten cases with three months of follow-up, the tumor diameters were diminished by 50% or more in eight cases, showed no change in one case and enlarged in one case. In the three cases followed-up for six months, the diameters of tumors were reduced by 50% or more in all the cases. Of the 22 cases, atelectasis occurred in 12 before therapy. The lungs expanded again in nine cases in the follow-up after treatment. Symptoms after therapy included metastases of the mediastinal lymph nodes in four cases, newly-occurring thoracic osseous metastases in one case and hepatic metastases in one case.Complications included pneumothorax in 11 cases and exfoliation of particles in one case.CONCLUSION The size of cancer can be markedly reduced after therapy by CT guided percutaneous implant of 1251 radioisotopes in tissues. It is an accurate and safe procedure and is effective for local metastasis.