125I放射性粒子植入联合放化疗治疗中晚期非小细胞肺癌的疗效观察  

Curative effect of iodine-125 brachytherapy and concurrent chemoradiotherapy for middle and advanced stage non-small cell lung cancer

作　　者：孙颖[1] 王宁[1] 郭占文[1] 阎英[1] 

机构地区：[1]沈阳军区总医院放疗科,110032

出　　处：《国际肿瘤学杂志》2017年第10期740-744,共5页Journal of International Oncology

摘　　要：目的回顾性分析125I放射性粒子植入联合放化疗治疗中晚期非小细胞肺癌（NSCLC）的疗效及安全性。方法82例周围型。NSCLC患者按照不同的治疗方法分为实验组（n=32）和对照组（n=50），实验组行“I放射性粒子植入联合同步放化疗治疗，对照组行同步放化疗治疗。两组患者均采用螺旋断层放疗，化疗方案采用Pc方案（紫杉醇＋顺铂）或TP方案（多西他赛＋顺铂）。观察有效率（RR）、无进展生存期（PFS）、总生存期（OS）及不良反应发生情况。结果实验组与对照组有效率分别为87．5％和76．0％，差异无统计学意义（x2=0．992，P=0．319）；中位PFS分别为16个月和11个月，差异有统计学意义（x2=5．216，P=0．022）；中位OS分别为26个月和19个月，差异无统计学意义（r=1．085，P=0．298）。实验组和对照组不良反应如放射性肺炎（18．75％：24．00％,X2=0．314，P=0．575）、放射性食管炎（25．00％：30．00％，r=0．242，P=0．623）、消化道反应（21．88％：26．00％，x2=0．180，P=0．671）、骨髓抑制（12．50％：16．00％,x2=0．014，P=0．907）和血气胸（6．25％：0，P=0．149）发生率的差异均无统计学意义。结论”I放射性粒子植入联合同步放化疗是中晚期NSCLC安全、有效的治疗方法，值得进一步研究和推广。Objective To review the efficacy and safety of combination of iodine-125 brachytherapy and concurrent chemoradiotherapy for middle and advanced stage non-small cell lung cancer （NSCLC）. Methods Eighty-two cases of peripheral NSCLC patients were divided into the experimental group （ n = 32 ） and the control group （n = 50） by different treatment methods. The patients in experimental group were treated by iodine-125 brachytherapy combined with concurrent chemoradiotherapy, and the patients in control group were treated by concurrent chemoradiotherapy. The two groups were treated with helical tomotherapy, and the chemotherapy regimen was PC regimen （paclitaxel ＋ cisplatin） or TP regimen （taxotere ＋ cisplatin）. The response rate （RR）, progression free survival （PFS）, overall survival （OS） and adverse reactions were observed. Results The RR of experimental group and control group was 87.5% and 76.0%, and the diffe- rence was not statistically significant （X2 =0. 992, P =0. 319）. The median PFS was 16 months and 11 months, and the difference was statistically significant （X2 = 5. 216, P = 0. 022）. The median OS was 26 months and 19 months, and the difference was not statistically significant （X2 = 1. 085, P = 0. 298 ）. There were no statistically significant differences of the occurrence rates of adverse reactions in the experimental group and the control group such as radioactive pneumonia （18.75% vs. 24.00% , X2 =0.314, P =0. 575） , radia- tion esophagitis （25.00% vs. 30.00%, X2 = 0. 242, P = 0. 623 ）, digestive tract reaction （ 21.88% vs. 26.00%,X2=0.180, P=0.671）, bone-marrow suppression （12.50% vs. 16.00%,X2 =0.014, P= 0. 907 ） and hemopneumothorax （6.25% vs. 0, P = 0. 149 ）. Conclusion The combination of iodine-125 brachytherapy with concurrent chemoradiotherapy is a safe and effective treatment for middle and advanced stageNSCLC, which is worthy of further research and promotion.

关 键 词：肺肿瘤 放射疗法 药物疗法 125I粒子近距离放射治疗 

分 类 号：R734.2[医药卫生—肿瘤]