支气管动脉化疗栓塞联合^(125)I粒子植入治疗老年性非小细胞肺癌疗效分析  

Bronchial artery chemoembolization combined with ^(125)I seeds implantation for the treatment of non-small cell lung cancer in senile patients: comparison with GP chemotherapy scheme

作　　者：宋晶晶[1] 纪建松[1] 赵中伟[1] 范晓希[1] 张登科[1] 

机构地区：[1]浙江丽水市中心医院介入科,323000

出　　处：《介入放射学杂志》2014年第2期159-163,共5页Journal of Interventional Radiology

摘　　要：目的探讨支气管动脉化疗栓塞联合125I放射性粒子植入治疗老年性非小细胞肺癌(NSCLC)的安全性、有效性,并与吉西他滨联合顺铂(GP)方案化疗的近期疗效进行对比分析。方法 82例Ⅲa~Ⅲb期不可手术切除的老年性NSCLC患者随机分成两组,研究组38例,行支气管动脉化疗栓塞联合125I放射性粒子植入治疗3~6个疗程;对照组44例行GP方案4~6个疗程全身静脉化疗,对比分析两组患者的疗效、不良反应发生率及生存率。结果研究组和对照组患者的治疗有效率分别为71.1%和43.2%(P<0.05),差异有统计学意义。局部控制率分别为84.2%和64.1%,差异无统计学意义(P>0.05)。研究组与对照组1年生存率分别为71.1%和52.1%,中位生存时间分别为399 d和336 d,差异均有统计学意义(P均<0.05)。研究组的不良反应率明显比对照组低,差异有统计学意义(P<0.05),其中125I放射性粒子植入的主要并发症为气胸。结论支气管动脉化疗栓塞联合125I放射性粒子植入治疗不可手术切除的Ⅲ期老年性NSCLC是一种安全、有效的治疗方法,毒副作用低,短期疗效优于GP方案化疗,是现阶段治疗老年晚期NSCLC患者的新选择。[Abstract] Objective To discuss the safety and effectiveness of bronchial artery chemoembolization combined with ~25I radioactive seeds in treating non-small cell lung cancer of senile patients, and to compare the short- term effect with that of GP chemotherapy scheme. Methods A total of 82 senile patients with inoperable Ilia - lllb stage non-small cell lung cancer were randomly divided into study group （n = 38） and control group （n = 44）. Patients in the study group were treated with bronchial artery chemoembolization combined with 125I radioactive seeds implantation for 3 - 6 cycles, while patients in the control group received GP systemic chemotherapy for 4 - 6 cycles. The therapeutic efficacy, the incidence of adverse reactions and the survival rate of both groups were determined, and the results were compared between the two groups. Results The total response rates of the study group and the control group were 71.1% and 43.2% respectively, and the difference between the two groups was statistically significant （P 〈 0.05）. The local tumor control rates of the study group and the control group were 84.2% and 64.1% respectively, and the difference between the two groups was not significant （P 〉 0.05）. The one-year survival rates of the study group and the control group were 71.1% and 52.1% respectively, and the median survival days of the study group and the control group were 399 days and 336 days （P 〈 0.05）, respectively. The adverse reaction of the study group was significantly milder than that of the control group, and the difference was statistically significant （P 〈 0.05）. The main complication due to 125I radioactive seeds implantation was pneumothorax. Conclusion For the treatment of inoperable Ⅲa - Ⅲ b stage non-small cell lung cancer of the aged patients, bronchial artery chemoembolization combined with 125I radioactive seeds implantation issafe and effective with fewer adverse reactions. Besides, its short- term efficacy is better than that of GP chemotherapy sche

关 键 词：非小细胞肺癌 支气管动脉化疗栓塞 125I放射性粒子 化疗 

分 类 号：R734.2[医药卫生—肿瘤]