表皮生长因子受体酪氨酸激酶抑制剂联合放射性粒子植入治疗肺癌的疗效分析  

EGFR-TKIS combined with radioactive ^(125)I seed implantation for the treatment of advanced non-small-cell lung cancer:analysis of clinical effect

作　　者：应希慧[1] 纪建松[1] 涂建飞[1] 赵中伟[1] 宋晶晶[1] 张登科[1] 吴敏华[1] 

机构地区：[1]丽水市中心医院介入科,肿瘤内科,浙江省丽水323000

出　　处：《介入放射学杂志》2015年第3期226-230,共5页Journal of Interventional Radiology

基　　金：浙江省丽水市公益性计划项目(2012ZC027)

摘　　要：目的探讨表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIS)联合125I放射性粒子植入治疗晚期非小细胞肺癌(NSCLC)的近期疗效和安全性。方法 48例ⅢB~Ⅳ期不可手术切除的、EGFR突变阳性的晚期NSCLC患者,分成A、B两组,A组26例,行EGFR-TKIS联合125I放射性粒子植入治疗;B组22例单纯行EGFR-TKIS治疗,直至进展,对比分析两组患者的疗效、不良反应发生率及生存率。结果A、B两组患者局部控制率分别为92.3%和68.2%,差异有统计学意义(P=0.033);治疗有效率分别76.9%和54.5%,差异无统计学意义(P=0.101)。研究组与对照组无进展生存时间(PFS)分别为14.1和9.7个月;1年生存率分别为80.8%和63.6%,中位生存时间分别为26.9和17.1个月,差异均有统计学意义(P<0.05)。125I放射性粒子植入的主要并发症为气胸。结论 EGFR-TKIS联合125I放射性粒子植入治疗EGFR突变的晚期NSCLC是一种安全、有效的疗法,短期疗效优于单纯EGFR-TKIS药物治疗,是现阶段治疗EGFR突变的晚期NSCLC患者的新选择。Objective To evaluate the short-term efficacy,safety and effectiveness of epidermal growth factor receptor tyrosine kinase inhibitors（EGFR-TKIs） combined with radioactive125 I seed implantation in treating advanced non-small-cell lung cancer（NSCLC）.Methods A total of 48 patients with inoperable and EGFR mutation-positive advance NSCLC were included in this study.The patients were divided into study group（n = 26） and control group（n = 22）.Patients in the study group were treated with EGFR-TKIs combined with radioactive125 I seed implantation; while patients in the control group only received EGFR-TKIs treatment,which was kept on until the disease progressed.The clinical efficacy,and the incidence of side effect as well as the survival rate were determined,and the results were compared between the two groups.Results Local disease control rate of the study group and the control group was 92.3% and 68.2%respectively,the difference was statistically significant（P = 0.033）,while the effective rate was 76.9% and54.5% respectively,the difference was not significant（P = 0.101）.Progression-free survival（PFS） time of the study group and the control group was 14.1 months and 9.7 months respectively（P〈0.05）.The one-year survival rate of the study group and the control group was 80.8% and 63.6% respectively（P〈0.05）,and the median survival time was 26.9 months and 17.1 months respectively（P〈0.05）.The major complication caused by radioactive125 I seed implantation was pneumothorax.Conclusion For EGFR mutation-positive advance NSCLC,EGFR-TKIs together with radioactive125 I seed implantation is a safe and effective treatment.Its short-term efficacy is superior to pure EGFR-TKIs therapy.At present,this combination therapy is a new alternative for the treatment of EGFR mutation-positive advance NSCLC.

关 键 词：非小细胞肺癌 表皮生长因子受体酪氨酸激酶抑制剂 ^125I放射性粒子 

分 类 号：R734.2[医药卫生—肿瘤]