^(125)Ⅰ粒子肿瘤内植入联合吉西他滨治疗周围性非小细胞肺癌  

Radioactive seed ^(125)Ⅰ implantation plus Gemcitabine in treatment for peripheral non-small cell lung cancer

作　　者：王馨[1] 吴炜新[1] 王卫星[1] 孙德军[1] 

机构地区：[1]厦门大学附属中山医院肿瘤科,361004

出　　处：《介入放射学杂志》2008年第3期194-196,共3页Journal of Interventional Radiology

摘　　要：目的探讨125Ⅰ粒子肿瘤内植入联合吉西他滨治疗周围性肺癌的临床价值。方法60例患者,经CT导引下经皮肺穿刺活检确诊为肺癌,腺癌43例(其中8例为肺泡细胞癌),鳞癌17例。临床分期Ⅰ期6例,Ⅱ期14例,Ⅲ期34例,Ⅳ期6例。所有患者均拒绝或无法手术,将患者随机分为2组:吉西他滨单药化疗组及吉西他滨化疗联合经皮穿刺CT导引下肿瘤内植入125Ⅰ粒子治疗组。结果吉西他滨组PR5例,SD14例,PD11例,总有效率为16%(5/30),疾病控制率为63%(19/30),临床受益率为37%(11/30);中位生存期为7个月,1年生存率为26%。吉西他滨联合治疗组CR5例,PR11例,SD8例,PD6例,总有效率为36%(16/30),疾病控制率为80%(24/30),临床受益率为56%(17/30),中位生存期为12.3个月,1年生存率为50%。差异有统计学意义(P<0.05)。治疗过程中吉西他滨单药组14例出现Ⅰ度骨髓抑制,9例出现皮疹,吉西他滨联合组11例出现皮疹,17例出现轻度骨髓抑制。结论125Ⅰ粒子肿瘤内植入联合吉西他滨治疗周围性肺癌疗效好,创伤小,不良反应发生率低。Objective To investigate the clinical value of radioactive seed 125↑Ⅰ implantation combined with gemcitabine（GEM）in treatment for peripheral non-small cell lung cancer（NSCLC）.Methods 60 patients（male 35,female 27,mean age 73.3）with peripheral lung carcinoma were confirmed under CT-guided biopsy including 8 bronchoalveolar caicinomas and 17 squamous carcinomas,6 in the stage Ⅰ,14 in the stage Ⅱ,34 in the stage Ⅲ and 6 in the stage Ⅳ were designated under clinical staging.All patients were devided into two groups as GEM group and GEM-125↑Ⅰ group.GEM group underwent chemotherapy with GEM only and GEM-125↑Ⅰ group was treated under CT guided radioactive seed 125Ⅰ implantation combined with gemcitabine.Results GEM group showed tumors under controlling as PR in 5,SD in 14,PD in 11 cases;the total effective rate was 16% and the total control rate was 63%.The median survival time was 7 months and one years survival rate was 26%.GEM-125↑Ⅰ group revealed CR in 5,PR in 11,SD in 8,PD in 6 cases and the total effective rate reached 36% with total control rate as 80%.The median survival time was 12.3 months and one year survival rate was 50%.There was a significant difference（P 〈 0.05）between two groups.Adverse events combined with were generally mild and reversible,including neutropenia and thrombocytopenia.Conclusions CT guided radioactive seed 125↑Ⅰ implantation combined with gemcitabine in treatment for the patients with peripheral non-small cell lung cancer（NSCLC）has fine clinical efficiency with minimal damage and few complications.

关 键 词：非小细胞肺癌 125↑Ⅰ粒子 吉西他滨 组织间放疗 

分 类 号：R734.2[医药卫生—肿瘤]