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山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (11): 11-19.doi: 10.6040/j.issn.1671-7554.0.2023.0981

• 学术前沿 • 上一篇    下一篇

CT引导经皮肺穿刺肿瘤内化疗技术流程

韩明勇1,*(),于晓黎1,曾放平1,谢兵2,芦兰1,瞿家权1,江璧锋1,唐斯晗1,谭洁1,梁瑾1,钟龙辉1,王柳1,赵宣植1   

  1. 1. 深圳大学附属华南医院肿瘤科，广东 深圳 518111
    2. 深圳大学附属华南医院放射科，广东 深圳 518111
  • 收稿日期:2023-11-02 出版日期:2023-11-10 发布日期:2023-12-12
  • 通讯作者: 韩明勇 E-mail:hanmingyong@sina.com
  • 作者简介:韩明勇，男，博士。现任深圳大学附属华南医院肿瘤科主任，主任医师。深圳大学教授，博士研究生导师。曾任山东大学附属省立医院东院区肿瘤科副主任, 山东大学教授，博士研究生导师。瑞典卡罗林斯卡医学院访问学者。临床和科研方向: 1.常见肿瘤的诊断和内科综合治疗；2.肿瘤转移和炎症反应的机制研究。承担课题：国家自然科学基金面上项目2项(负责人)，山东省自然科学基金项目2项(负责人)。已获山东省科技进步二等奖2项(分别为第2位、第3位)，山东省科技进步三等奖1项(第3位)，山东省医学科技创新成果三等奖1项(第1位)。工作至今已发表文章39篇，其中作为第一作者和通讯作者被SCI收录论文22篇。社会兼职：兼任中国抗癌协会肿瘤微创治疗专业委员会放射性粒子分会常委，中国医师协会肿瘤介入医师分会放射性粒子专委会常委，中国抗癌协会肿瘤微创治疗专业委员会肺癌分会常委。山东省医师协会肿瘤介入医师分会放射性粒子专业委员会主任委员，山东省医师协会肿瘤医师分会副主任委员
  • 基金资助:
    国家自然科学基金面上项目(81670046)

Technical procedure of CT-guided intratumoral chemotherapy for lung tumor

Mingyong HAN1,*(),Xiaoli YU1,Fangping ZENG1,Bing XIE2,Lan LU1,Jiaquan QU1,Bifeng JIANG1,Sihan TANG1,Jie TAN1,Jin LIANG1,Longhui ZHONG1,Liu WANG1,Xuanzhi ZHAO1   

  1. 1. Department of Oncology, South China Hospital of Shenzhen University, Shenzhen 518111, Guangdong, China
    2. Department of Radiology, South China Hospital of Shenzhen University, Shenzhen 518111, Guangdong, China
  • Received:2023-11-02 Online:2023-11-10 Published:2023-12-12
  • Contact: Mingyong HAN E-mail:hanmingyong@sina.com

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摘要：

肺癌在我国的发病率和死亡率均居所有肿瘤之首。目前，手术、化疗、放疗、靶向治疗、免疫治疗等局部与全身治疗是有效的治疗方法。近年，肿瘤内化疗的开展逐渐成为肿瘤治疗领域的焦点。利用超声、支气管镜、超声支气管镜、超声内窥镜或CT等影像学和介入方式进行肿瘤穿刺和给药。化疗药物如顺铂、卡铂、丝裂霉素、紫杉醇脂质体、氟尿嘧啶原液或稀释液通过穿刺针直接注入癌组织称为瘤内化疗。瘤内化疗可增加化疗药物在肿瘤组织中的浓度，降低药物的全身不良反应，提高肿瘤的局部控制率。深圳大学附属华南医院肿瘤科开展了肺癌、肝转移瘤、骨转移瘤瘤内化疗的临床应用与探索性研究，并观察了患者获益情况和初步疗效。本文总结了CT引导下经皮肺穿刺肿瘤内化疗的技术流程。

关键词: 肿瘤内化疗, 肺肿瘤, CT引导, 技术流程

Abstract:

The incidence and mortality rates of lung cancer in China rank the first of all tumors. At present, there are many effective treatment methods, including surgery, chemotherapy, radiotherapy, targeted therapy, immunotherapy and other local and systematic treatments. In recent years, intratumoral chemotherapy, which combines the advantages of local therapy and systemic therapy, has gradually become the focus. By using ultrasound, bronchoscope, ultrasonic bronchoscope, endoscopic ultrasonography or CT and other imaging and interventional modalities, chemotherapeutics such as cisplatin, carboplatin, mitomycin, paclitaxel liposomes, fluorouracil in stock or diluted solutions are directly injected into the cancer tissue through the puncture needle. Intratumoral chemotherapy can increase the concentration of chemotherapeutics in the tumor tissue, reduce the systemic toxicity and side effects, and improve the local control rate of cancers. We have carried out clinical application and exploratory research on intratumoral chemotherapy for lung cancer, liver metastasis and bone metastasis, and observed patients' benefits and primary efficacy. This paper will summarize the technical procedure of CT-guided intratumoral chemotherapy.

Key words: Intratumoral chemotherapy, Lung tumor, CT-guided, Technical procedure

中图分类号: 

  • R734.2

图1

患者体位及穿刺点选择 A：选择合适的体位并放置CT定位纸；B：进行CT扫描；C：选择合适的穿刺点；D：体表进行标记。"

图2

麻醉及穿刺 A：穿刺前检查穿刺针，排空管内空气；B：麻醉后穿刺针缓慢进针；C：穿刺针进入肿瘤；D：调整穿刺针到达计划位置。"

图3

药物注射以及并发症 A：穿刺针的针尖首先到达肿瘤的最远处；B：少量药物渗漏；C：少量气胸；D：大量气胸。"

图4

CT引导经皮肺穿刺肿瘤内化疗技术流程"

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