组织间粒子植入联合化疗与外照射联合化疗治疗非小细胞肺癌的近期疗效对比研究  

Short-term efficacy comparison study of chemotherapy respectively combining with implantation of ^125I radioactive seed and external beam radiotherapy in non-small cell lung cancer

作　　者：高立伟[1] 刘宏[1] 党国际[2] 

机构地区：[1]河南省平顶山煤业集团总医院肿瘤科,467000 [2]河南省平顶山煤业集团总医院核医学科,467000

出　　处：《中国实用医刊》2013年第20期60-63,共4页Chinese Journal of Practical Medicine

摘　　要：目的比较^125I粒子组织间植入和外放疗分别联合PC方案（紫杉醇联合顺铂）化疗治疗非小胞肺癌的疗效与安全性。方法将87例非小细胞肺癌患者分为两组，观察组44例接受^125I放射性粒子植入后联合同步PC方案化疗，对照组43例接受外放疗同步PC方案化疗。结果观察组和对照组有效率分男别为88．63％和69．77％，差异有统计学意义（P=0．030）；局部控制率分别为97．72％和88．37％，差异无统计学意义（P=0．085）。主要不良反应：研究组为气胸（5例，其中1例为大量气胸）、血胸（1例），未发现有针道种植转移的患者。对照组主要不良反应为放射性肺炎（17例）、肺间质纤维化（5例）、呼吸衰竭（2例）、放射性食管炎（11例）、放射性心脏损伤（2例）。血液学毒性两组比较差异无统计学意义，但研究组发生率较低。结论放射线^125I粒子组织间植入联合同步PC方案化疗相对于外照射联合同步PC方案化疗治疗非小细胞肺癌患者具有更好的有效率和安全性，可作为非小细胞肺癌的一种有效而安全的治疗手段。Objective To evaluate the efficacy and toxicity of PC （paclitaxel combined with cis-platin） regimen chemotherapy respectively combined with implantation of ^125I seed by CT-guided percuta-neous insterstieial brachytherapy and external beam radiotherapy in non-small cell lung cancer （NSCLC）. Methods Eighty-seven patients with NSCLC were enrolled in a randOmized, two-armed clinical trial. Among these patients, 44 patients （the observed group） received a concurrent treatment of PC regimen combining with CT-guided percutaneous ^125I seed instersticial implantation, while 43 patients （the control group） received concurrent PC regimen chemotherapy combining with external beam radio-therapy. Results The response rate （RR） was 88.63% in the observed group and 69.77% in the con-trol group, there was significant difference （P = 0. 030）. The disease control rate （DCR） was 97.72% in the observed group and 88.37% in the control group, there was significant difference （ P = 0. 085 ）. The complications in the observed group included 5 cases of pneumothorax and 4 cases of hemothorax, without implantation metastasis at the needle passage. The complications in the control group included 17 cases of radiation pneumonia, 5 cases of radiation pulmonary interstitial fibrosis, 2 cases of respiratory failure, 11 cases of radiation esophagitis, 2 cases of radiation cardiac trauma. The incidence of myelosup-pression was lower in the observed group than that in the control group, but there was no significant differ-ence. Conclusions Combined CT-guided ^125I radioactive seed implantation and PC regimen chemotherapy are effective and safe for treating NCSLC compared with concurrent PC regimen chemotherapy combining with external beam radiotherapy, and can be an effective and safe scheme for NSCLC.

关 键 词：非小细胞肺癌 125碘粒子植入 外照射 

分 类 号：R734.2[医药卫生—肿瘤]