射频消融联合125I粒子植入治疗非小细胞肺癌骨转移的临床应用  

Clinical application of radiofrequency ablation combined with I seed implantation in treating bone metastases of non-small cell lung cancer

作　　者：杨乐[1] 李鸿丽[1] 崔国金[1] YANG Le;LI Hongli;CUI Guojin(Department of Nuclear Medicine,Daqing Oilfield General Hospital,Daqing,Heilongjiang Province 163001,China)

机构地区：[1]大庆油田总医院核医学科,黑龙江163001

出　　处：《介入放射学杂志》2020年第8期783-787,共5页Journal of Interventional Radiology

摘　　要：目的探讨射频消融(RFA)联合125I粒子植入治疗非小细胞肺癌(NSCLC)骨转移的疗效及预后。方法选取2012年1月至2016年1月我院收治的177例NSCLC骨转移患者作为研究对象。按照治疗方法将患者分为观察组(n=89)和对照组(n=88),观察组采用RFA联合125I粒子植入治疗,对照组采用RFA治疗,观察两组临床疗效、安全性及预后。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05)。两组均有并发症发生,观察组患者并发症总发生率高于对照组(P<0.05),但经对症处理后均得到缓解。观察组患者中位生存时间高于对照组,差异有统计学意义[19(95%CI:17~22)个月对比10(95%CI:9~15)个月,P<0.05]。Cox单因素及多因素回归分析显示骨转移数目、ECOG PS评分、既往治疗及治疗方案与NSCLC骨转移患者预后密切相关。结论RFA联合125I粒子植入较RFA单独治疗NSCLC骨转移疗效好,安全性尚可,且能改善患者预后。Objective To investigate the curative effect and patient’s prognosis of radiofrequency ablation(RFA)combined with125I seed implantation in the treatment of bone metastases of non-small cell lung cancer(NSCLC).Methods A total of 177 NSCLC patients associated with bone metastases,who were admitted to authors’hospital to receive treatment during the period from January 2012 to January 2016,were enrolled in this study.According to the treatment method,the patients were divided into observation group(n=89)and control group(n=88).RFA combined with125I seed implantation was adopted in the patients of the observation group,while simple RFA was employed in the patients of the control group.The clinical curative effect,safety and prognosis were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Complications occurred in both groups.The total incidence of complications in the observation group was remarkably higher than that in the control group(P<0.05),but all the complications were relieved after symptomatic treatment.The median survival time in the observation group was 19 months(95%CI:17-22 months),which was strikingly higher than 10 months(95%CI:9-15 months)in the control group,and the difference was statistically significant(P<0.05).Cox univariate and multivariate regression analysis showed that the prognosis of NSCLC patients associated with bone metastases was closely related to the number of bone metastatic lesions,ECOG PS score,history of previous treatment and therapeutic scheme.Conclusion RFA combined with125I seed implantation is superior to simple RFA in treating NSCLC associated with bone metastases.Clinically,RFA combined with125I seed implantation is quite safe and can reliably improve the prognosis of patients.

关 键 词：射频消融术 125I粒子 非小细胞肺癌 骨转移 疗效 预后 

分 类 号：R734.2[医药卫生—肿瘤]