[Abstract] Objective To investigate the clinical value of CT guided radioactive seed 125I implantation（CTRISI） in the treatment of localized advanced pulmonary carcinoma. Methods Thirty-two patients (Group A) with localized advanced pulmonary carcinoma, received radioactive seed 125I implantation after failure in first line chemotherapy. There were 15 males, and 17 females, ageing from 31 to 73 years old, 52.0 on the average. There were 48 lesions in the 32 patients altogether and all the lesions had a clear border with the adjacent normal tissue. The diameter of tumors was 4.5-7.5cm , the average was 5.5cm. All the cases had been confirmed as malignant by pathology (percutaneous aspiration biopsy). 125I seeds of 2.2~3.3×107 megabecquerel（MBq）were implanted into these lesions. The total number of the seeds implanted in each lesion was 10～100. The dosage of the region around the tumor was 100~150Gy. According to Treatment Planning System (TPS), we implant the 125I seeds into the tumors under CT guidance . We picked 30 patients (Group B) to be treated by first line chemotherapy in our hospital randomly as the control group. Results The results of CT follow-up after two months proved that the local control rate of the group treated with 125I seeds implantation was 78.1%, one year survival rate was 65.0%, median survival time was 15 months. Small amount of effusion was observed in these patients during operation. Pneumothorax happened in 4 cases with one of the lungs compressed less than 30 percent and got improved healthy after conservative treatment. One week after the procedure, bloody sputum occured in 15 cases. No medullary suppression and other serious complications occurred in these patients. The local control rate of the control group was 43.3%, one year survival rate was 48.0%, median survival time was 11 months, the incidence rate of medullary suppression is 46.3%. There was a significant difference between the two groups. Conclusion CTGRISI procedure is safe and well-tolerated in treating localized advanced pulmonary carcinoma in Chinese patients with few complications; it can improve the living quality obviously and has good short-term effects.
【Key words】Iodine radioisotopes; interventional; brachytherapy; localized advanced stage pulmonary carcinoma; evaluation studies