诱导化疗配合局部植入放化疗粒子治疗晚期非小细胞肺癌的临床观察  

Induction chemotherapy combined with radio-chemotherapy with interstitial implantation of ^(125)Ⅰ seeds and slow-release seeds for advanced non-small cell lung cancer.

作　　者：张文莉[1] 高宏[1] 杜伟生[1] 薛文英[1] 李力军[1] 

机构地区：[1]北京世纪坛医院肿瘤中心,北京100038

出　　处：《临床肿瘤学杂志》2006年第4期286-288,共3页Chinese Clinical Oncology

摘　　要：目的观察诱导化疗配合同期局部植入放化疗粒子治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法66例Ⅲ期NSCLC患者分为两组。粒子植入组32例,在诱导化疗2周后,同时植入放射性粒子及缓释化疗粒子,平均每例患者应用放射性粒子125Ⅰ28粒,缓释化疗粒子(顺铂)80mg。同期放化疗组(外照射+全身化疗)34例,采用15MVX线放射治疗,照射野包括肺部原发灶和纵隔淋巴引流区,剂量65~70Gy,每周放疗第1日应用顺铂20mg。结果粒子植入组和同期放化疗组1、2年生存率分别为93·75%、70·60%和68·75%、32·35%(P<0·05)。两组的完全缓解率分别为56·20%和21·30%,粒子植入组明显高于同期放化疗组,两组差异有显著性意义(P<0·05)。结论在诱导化疗的基础上放射性粒子125Ⅰ和缓释化疗粒子联合应用局部植入技术是综合治疗晚期非小细胞肺癌的较有效手段之一。Objective： To observe the clinical efficacy of inductive chemotherapy combined with interstitial implantation of ^125Ⅰ seeds and slow-release seeds for advanced non-small cell lung cancer （NSCLC）. Methods：66 patients with advanced unresectal- ble NSCLC were enrolled in a prospective randomized study. 32 cases of seeds implantation group consisted of 2 cycles of induction chemotherapy, followed by concurrent seeds implantation with slow-release seeds and ^125Ⅰ seeds. The MPD （Matched peripheral dose） of 125^Ⅰ seeds implantation was 140-160Gy. The concurrent radio-chemotherapy was given with a dose of 65-70Gy. The treatment fields covered clinical tumor and lymph node. Radio-chemotherapy group patients were also given with concurrent chemotherapy （DDP 20mg/m2 · dl/w）. Results： 1 year and 2 year survival rate in group of seeds implantation were 93.75% and 70. 60% ,while in group of concurrent radio-chemotherapy were 68. 75% and 32. 25% respectively. The CR rates of two groups were 56. 20% and 21.30% respectively. Conclusion ： Induction of chemotherapy combined with interstitial implantation of 125 Ⅰ seeds and slow-release seeds is effective for unresectable advanced NSCLC.

关 键 词：非小细胞肺癌 诱导化疗 放射治疗 放射性粒子125Ⅰ 缓释化疗粒子 

分 类 号：R734.205[医药卫生—肿瘤]