Objective To evaluate the short-term effect of CT-guided interstitial implantation of 125I seeds for metastatic lung carcinoma. Methods A total of 82 patients with 126 metastatic lung tumors were treated with CT-guided percutaneous interstitial implantation of 125I seeds at a dose of 80 Gy. Six months after the treatment, the change of tumor volume was observed by using CT scan. The patients were followed up for 2 years. Results The mean radioactive dose was (159.3?34.5) Gy, and the median dose was (118.6?33.2) Gy. Six months after the treatment, CT scan showed a CR of 25.4% (32/126), PR 64.3% (81/126), NC 6.3% (8/126), PD 4.0% (5/126), and CR+PR 89.7% (113/126). Twelve patients showed pneumothorax and 41 had hemoptysis. During the follow-up, 11 patients (6 cases of malignant fibrous histiotoma, 3 cases of lung cancer, 1 rectal carcinoma, and 1 liver carcinoma) died within 8-12 months after the surgery. Fifteen patients (4 cases of malignant fibrous histiotoma, 4 lung cancer, 4 ovarian cancer, 2 multiple myeloma, and 1 uterine leiomyosarcoma) died within 13-24 months after the implantation. The 1-and 2-year survival rates were 86.6% (71/82) and 68.3% (56/82) respectively. Conclusion CT-guided percutaneous interstitial implantation of 125I seeds is effective for lung metastatic carcinoma.

Objective To evaluate the short-term efficacy of interstitial implantation of 125I seeds by using flexible fiberoptic bronchoscope (FFB) guided by CT for advanced non-small cell lung cancer (NSCLC). Methods A total of 185 patients with NSCLC, who were diagnosed clinically and pathologically, were enrolled into this study and divided into two groups. In 125I seeds group (n=121), the patients received interstitial implantation of 125I combined with NP regimen (NVB+DDP) chemotherapy with a prescribed dose (PD) of 80 Gy. Among the patients, the implantation was guided by CT in 89, and was performed directly under a FFB in 32. In control group (n=64), NP regimen (NVB+DDP) chemotherapy was used. Six months after the treatments, the tumor volume in the two groups was measured by using CT and FFB. The outcomes of the 2 groups were compared, and the efficacy of the treatments was evaluated according to the international standards. Results In the 125I seeds group, the mean radiation dose was 153.7 Gy, matched peripheral dose (MPD) was 89.6 Gy, and D90 was 93.5 Gy. Six months after the treatment, the effectiveness rate (CR+PR) was 95.0% (115/121), and 1-year survival rate was 0.90. In the control group, the effectiveness rate was 42.2% (27/64), and 1-year survival rate was 0.65. There existed significant difference between the two groups (log-rank test, ?2=5.12, Prob=0.04

Objective:This study aimed to observe the clinical efficacy of implanting radioactive 125I seeds to treat non-small cell lung cancer (NSCLC) on the basis of the recent changes in serum tumor markers (including CEA, CA125, SCC-Ag, and CYFRA21-1). Methods:We selected 72 patients who were pathologically confirmed with NSCLC and received CT-guided percutaneous implantation of radioactive 125I seeds from January 2009 to June 2012. The concentration of the serum tumor markers was detected 3 d before implan-tation and 1, 2, 3, and 6 months after implantation. Result:All of the operations were successfully completed. One month after implan-tation, a significant change was observed in the concentration of serum tumor markers (CEA, CA125, SCC-Ag, and CYFRA21-1) com-pared with their preoperative levels (P<0.01). No significant difference was observed between the different time points after implanta-tion. Conclusion:The treatment of NSCLC by implanting radioactive 125I seeds can effectively reduce the level of tumor markers. A sig-nificant difference was observed in the level of tumor markers between patients with different efficacy classifications.

Objective To investigate the short-term clinical efficacy of CT-guided percutaneous implantation of 125I radioactive seeds in treating the postoperative lung metastases of malignant fibrous histiocytoma(MFH).Methods Eight patients with lung metastases after MFH surgery received CT-guided percutaneous implantation of 125I radioactive seeds.There are 28 metastasis lesions in total.Prescribed dose (PD) was 80 Gy and radioactivity was 0.7 mCi(2.59 × 107 Bq).Six months after implantation,chest CT-scan was performed and the changes were reviewed according to the international standards.ResultsAverage dose received by tumor was ( 172.9 ± 39.9 ) Gy,D100 ( 77.7 ± 10.2 ) Gy and D90 ( 97.2 ± 6.8 ) Gy.The overall response rate was 82.1％.Patients' survival period was 10.0 - 26.0 ( 14.6 ± 3.5 ) months with the median survival time of 13 months.ConclusionIn the treatment of postoperative lung metastases of MFH,implantation of 125I radioactive seeds produces a good short-term clinical efficacy.

By means of joint research of new advanced technology project,joint development and application of appropriate health technology project,comprehensive prevention and control of chronic diseases between municipal hospitals and community clinics project and research supporting platform project,Shanghai Hospital Development Center has effectively improved the clinical science and technology innovation capability, promoted the development of medical disciplines and talents and improved the discipline influence of such hospitals.

Objective To observe the pulmonary protective effect of large and small doses of mucosolvan in elderly patients with lung cancer undergoing radioactive seed implantation.Methods 93 patients with non-small cell lung cancer undergoing radioactive seed implantation guided by CT were selected and randomly divided into 3 groups:the high-dose group,the low-dose group and control group (n-31,each).All patients received the mucosolvan treatment with routine immunization and nutrition support after implantation.Patients was given mucosolvan 990 mg/d and 300 mg/d by continuous intravenous pumping in high-dose and small-dose groups respectively.Patients in the control group was given saline.The incidence of pneumothorax and plasma levels of C reactive protein (CRP),tumor necrosis factor alpha (TNF alpha),neutrophils (ANC) were compared between the three groups at 1 d,3 d and 5 d after implantation.Results There was no statistically significant difference in plasm levels of CRP,TNF alpha and ANC between the three groups at 1 d and 3 d after implantation (all P＞0.05).Plasma levels of CRP,TNF alpha and ANC were lower in highdose group than in low-dose group and control group at 5 d after implantation (F=3.596,3.555,3.406,respectively,all P＜0.05).The incidence of pneumothorax was lower in high dose group than in control group (x2 =4.31,P ＜ 0.05).Conclusions Perioperative application of high-dose mucosolvan can relieve lung inflammatory reaction rapidly and reduce the incidence of pneumothorax in elderly lung cancer patients undergoing radioactive seed implantation.

ObjectiveTo analyze therapeutic efficiency of 125 iodine brachytherapy seeds implantation guided by flexible fiber-optic bronchoscopy(FFB)image in terminal central non-small cell lung carcinoma (NSCLC).MethodsUnder therapy planning system (TPS) and guided by flexible fiber-optic bronchoscopy image,125 iodine seeds were implanted in 66 Confirmed terrainal cases with NSCLC and its posology Was validated and rechecked regularly.Remlts Complete remission (CR) was observed in 15 cases and partial remission (PR) in 36 cases during the first-year follow-up,with an overall efficiency rate (CR+PR) of 77.3 percent and one-year survival of 80.3 percent.Complete remission (CR) was observed in seven cases,partial remission (PR) in 22 cases,stable condition (SC) in three cases.and no progression was found during the second-year follow-up,respectively,with an overall efficiency rate (CR+PR) of 90.6 percent and two-year survival of 43.8 percent No radioactive damage were observed in the early and late stages of therapy.ConclusionsTherapy with radioactive 125 iodine seeds implantation guided by flexible fiber-optic bronchoscopy image could relieve airway obstruction effectively in terminal lung cancer and control progression of bronchiogenic carcinoma.

Objective:To improve the therapeutic gain ratio from 125I seed implants by investigating the QA/QC strategies used in brachytherapy treatment of lung cancer. Methods:A total of 287 lung cancer and pulmonary metastases cases were studied. Among which, 184 are male and 103 are female with a mean age of 61.9 years. The NOA-NSCLC subgroup and pulmonary metastases were targeted on conventional CT positioning. Considering that COA-NSCL subgroup on the tumor target area is difficult to determine with CT, the coincidence circuit SPECT was used to assist in positioning. A dose-volume histogram was constructed to evaluate the quality of the TPS and optimization. Corrections on real-time positioning are necessary when using an image-guided implantation. The C-LC should be aligned with the FFB for CT-guided percutaneous puncture implantation. After implantation, dosimetry verification was con-ducted. Results:The NOA-NSCLC subgroup, comprising the risk organs such as heart, lung, and spinal column, received an average dose of 137, which was significantly lower than that of normal tissue dose tolerance. The NOA-NSCLC subgroup and lung metastases have matched peripheral dosages of 92.1 and 106.2 Gy with local-control efficiency rates of 91.97% (126/137) and 96.0% (48/50), 1-year survival rates of 91.24%and 83.4%(42/50), and 2-year survival rates of 50.36%(69/137) and 52.3%(26/50), respectively. The 35 COA-NSCL subgroup and 65 lung cancer group have local control efficiency rates of 91.43%(32/35) and 92.3%(60/65) and 1-year survival rates of 88.57%(31/35) and 80.30%(53/66), respectively. Conclusion:Proper radiation dosimetry as a QA/QC strategy was found to improve particle-implantation therapy gain and greatly reduce the risks of radiation pneumonia and pulmonary fibrosis.

Objective:To evaluate the curative effect of computed tomography (CT)-guided percutaneous implantation of 125I radioactive seeds on inoperable early-stage non-small cell lung cancer (NSCLC). Methods:From January 2003 to December 2012, we selected 48 patients who had pathologically confirmed early-stage NSCLC (stageⅠ, 18 cases;stageⅡ, 30 cases with N0). We treated the nidus by CT-guided percutaneous implantation of 125I radioactive seeds. Six months after implantation, the chest CT-scan was reviewed, and the effect of the treatment was evaluated according to the international standards. Final follow-up was performed in December 2013. Results:All operations were successfully completed. The target tumor matched peripheral doses (MPDs) were 215.8±14.3 Gy (D100), 106.8±11.6 Gy (D90), and 148.6± 17.3 Gy (D90>MPD). Six months after implantation, chest CT was reviewed, and treatment effects were evaluated. The percentages of stage I patients achieving complete relief (CR), partial relief (PR), stable disease (SD), and progressive disease (PD) were 27.8%(5 cases), 72.2%(13 cases), 0%, and 0%, respectively. Among stageⅡpatients, CR, PR, SD, and PD percentages were 0%(3 cases), 73.3%(22 cases), 13.3%(4 cases), and 3.3%(1 case), respectively. The effective rate was 89.6%. The 1-year local control rate was 85%. Until December 2013, the 1-, 2-, and 5-year cumulative survival rates up to the end of the interval were 95.8%(46/48), 81.3%(39/48), and 56.3%(27/48), respectively. Conclusion:CT-guided percutaneous implantation of 125I radioactive seeds is an effective micro-invasive method for treating inoperable early-stage NSCLC.

Objective To explore the clinical value of the thin-section CT scanning in all the steps of non-small cell lung cancer (NSCLC) therapy through 125I seed implantation. Methods In the 137 patients who were diagnosed with non-small cell cancer (NSCLC), the preoperative targets were delineated by CT scan, and the implantation plan was accom-plished according to treatment planning system (TPS); Intraoperative 125I seeds were implanted under the guidance of CT, then their positions were confirmed and corrected by CT scan layer-by-layer in real time;Post implantation dosimetry was validated also under the help of CT scan. If necessary, distribution and number of seeds should be adjusted to conform dose distribution under the principle of effectivity and micro-invasion;Follow-up and periodic evaluation should also be accom-plished by CT scan. Results Dose-volume histograms (DVHs) showed that the dose in line with the targets meet the re-quirement of prescription dose while the surrounding organs at risk were within the scope of their tolerance dose. Among 137 patients, implanted seeds number was the same with seeds number of TPS plan in 129 patients, and the coincidence rate was 94%. CT scan showed the local control efficient rate was 91.9%after 6 months. The 1-year and 2-year survival rates were 91.2%and 50.4%respectively. No serious operation-led complication was found during treatment. Conclusion The thin-section CT could be applied in all key steps of 125I seed implantation in NSCLC therapy, especially it is clinical significant and irreplaceable in quality assurance and control of seed implantation therapy.