CT导引下^(125)Ⅰ粒子组织间植入联合支气管动脉灌注化疗治疗肺癌  

The Analysis of Curative Effect of Combined Treatment of CT Guided Percutaneous ^(125)Ⅰ Seed Implantation with Bronchial Arteral Infusion Chemotherapy for Lung Cancer

作　　者：贺克武[1] 高斌[1] 秦汉林[1] 李劲松[1] 黄永翠[1] 张宇东[1] 彭晓正[1] 汪涛[1] 杨会军[1] 陈昊[1] 

机构地区：[1]合肥市第一人民医院影像中心,安徽合肥230061

出　　处：《临床放射学杂志》2012年第7期1018-1022,共5页Journal of Clinical Radiology

摘　　要：目的评价CT导引下125Ⅰ粒子组织间植入联合经支气管动脉灌注化疗治疗进展期肺癌的疗效和安全性。方法 108例Ⅲ～Ⅳ期肺癌患者随机分为联合治疗组和灌注化疗组,联合治疗组43例57个病灶接受CT导引下125Ⅰ放射性粒子植入后,联合同步支气管动脉内GP方案化疗2～4个周期,灌注化疗组65例患者74个病灶仅接受支气管动脉内GP方案化疗2～4个周期,比较两组患者的疗效和毒性反应的发生率。结果 1、3、6、12个月两组总缓解率分别为8.8%、56.1%、63.6%、84.0%和2.7%、21.0%、41.9%、45.1%,差异有统计学意义(P<0.01或P<0.05)。联合治疗组和灌注化疗组1年累计生存率分别为91%和65%,中位生存时间分别为533天和422天,差异有统计学意义(P<0.01)。CT导引下125I粒子植入的主要并发症为气胸、咯血、放射性粒子游走和胸腔积血,化疗主要的毒性反应为骨髓抑制和胃肠道反应等,患者可以耐受,联合治疗组和灌注化疗组患者各化疗毒副反应的总发生率差异均无统计学意义(均P>0.05)。结论 CT导引下125I粒子组织间植入联合经支气管动脉灌注化疗治疗肺癌是一种安全、有效、微创的治疗方法。Objective To evaluate the efficacy and safety of combined treatment consisting of CT guided percutaneous t25I seed implantation with bronchial arteral infusion chemotherapy for advanced lung cancer. Methods 108 patients with advanced lung cancer were enrolled and randomly divided into two groups, Of these patients ,43 patients with 57 nidi re- ceived a combination treatment of CT guided percutaneous 12sI seed implantation with 2 - 4 cycles of GP bronchial arteral in- fusion chemotherapy （the combination therapy group）, while 65 patients with 74 nidi were treated with 2 -4 cycles of GP bronchial arteral infusion chemotherapy only （ the infusion chemotherapy group）. Results The overall response rate of the two groups after 1,3,6,12 months were 8.8%, 56.1%, 63.6% ,84.0% and 2.7%, 21. %, 41.9%, 45.1% respective- ly. The 1 year survival rates of the two groups were 91% and 65% respectively. The median overall survival time was 533 days in the combination therapy group and 422 days in the infusion chemotherapy group. The main complications of CT guided percutaneous 125I seed implantation were pneumothorax, hemoptysis, seeds shift and pleural cavity bleeding. Chemo- therapy treatment related toxicities, including myelosuppression and gastrointestinal toxicity, can be tolerated and was simi- lar in both groups. Conclusion Combined CT guided ~25I radioactive seed implantation with bronchial arterial infusion GP chemotherapy is a safe, effective and minimal damage for treating advanced lung cancer.

关 键 词：碘放射性同位素 近距离放疗 肺癌 介入治疗 

分 类 号：R734.2[医药卫生—肿瘤]