^(125)I粒子植入的靶区勾画对一线治疗后局部进展的非小细胞肺癌治疗效果影响  

Effect of target delineation of ^(125)I seed implantation on the treatment of locally advanced non-small cell lung cancer after first-line therapy

作　　者：严一杰 张军[1] 王硕[1] 孟繁杰 王斌[1] 关志宇[1] YAN Yi-jie;ZHANG Jun;WANG Shuo;MENG Fan-jie;WANG Bin;GUAN Zhi-yu(Department of Thoracic Surgery,The Second Hospital,Tianjin Medical University,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院胸外科,天津300211

出　　处：《天津医科大学学报》2021年第6期586-590,共5页Journal of Tianjin Medical University

摘　　要：目的:探讨一线放化疗后局部进展非小细胞肺癌(NSCLC)^(125)I粒子植入术中靶区勾画方式对肿瘤治疗效果的影响。方法:选取2017年10月—2019年12月一线治疗后局部进展NSCLC患者70例,分为两组,每组35例,对照组沿胸部CT肺窗肿瘤边缘直接划定靶区,观察组以胸部CT肺窗肿瘤外边缘7 mm为靶区。比较两组植入前和植入后6个月的胸部CT表现,并在1年随访中比较两组术后不良反应发生率、客观缓解率、原位肿瘤复发率和无进展生存期。结果:两组患者均顺利完成植入,不良反应发生率比较差异无统计学意义(20.0%vs.17.1%,P=0.759),客观缓解率比较差异无统计学意义(91.43%vs.85.71%,P=0.710),观察组原位复发率低于对照组(5.71%vs.25.71%,P=0.022)。随访1年,中位无进展生存期高于对照组(12.58个月vs.11.36个月,P=0.037)。结论:胸部CT肺窗肿瘤外缘7 mm勾画靶区,行^(125)I粒子植入可减少肿瘤原位复发,延长生存期。Objective:To investigate the effect of target delineation during ^(125)I seed implantation on tumor recurrence in patients with locally advanced non-small cell lung cancer after first-line treatment.Methods:A total of 70 patients with locally advanced non-small cell lung cancer after first-line treatment in our hospital from October 2017 to December 2019 were divided into two groups:control group(n=35)and observation group(n=35).The target area was directly delineated along the edge of chest CT lung window tumor in the control group and 7 mm on the outer edge of chest CT lung window tumor in the observation group.The chest CT findings before and 6 months after implantation were compared between the two groups,and the incidence of postoperative adverse reactions,objective remission rate,tumor recurrence rate in situ and progression free survival were compared between the two groups during 1-year follow-up.Results:The two groups were successfully implanted,the incidence of adverse reactions had no significant difference(20.0%vs.17.1%,P=0.759),the objective remission rate had no significant difference(91.43%vs.85.71%,P=0.710),the in situ recurrence rate of the observation group was lower than that of the control group(5.71%vs.25.71%,P=0.022).One year follow-up showed that the median progression free survival of the observation group was higher than that of the control group(12.58 months vs.11.36 months,P=0.037).Conclusion:The target area is delineated 7 mm from the outer edge of chest CT lung window tumor,and implanted with ^(125)I seeds can reduce tumor recurrence in situ and prolong the survival time.

关 键 词：非小细胞肺癌 ^(125)I放射性粒子植入 靶区勾划 肿瘤复发 

分 类 号：R734.2[医药卫生—肿瘤]