摘要
目的:探讨CT导向下^(125)I粒子植入治疗局部晚期非小细胞肺癌的临床意义。方法:对2006年7月-2007年7月在我院确诊的112例非小细胞肺癌患者随机分为两组,应用CT导向下经皮穿刺组织间植入^(125)I粒子56例(A组),植入时均根据肿瘤大小确定^(125)I总活度、粒子植人数及粒子分布。传统全身化疗56例(B组),采用TP方案化疗4周期。结果:A组56例患者实施手术均成功,随访2个月-18个月,8例肿瘤完全消失,32例部分缓解,11例稳定,5例进展,中位生存期14.6个月。A组总有效率(CR+PR)为71.43%,1年生存率与2年生存率分别为67.86%(38/56)和26.79%(15/56);B组总有效率为42.86%,1年生存率与2年生存率分别为57.14%(32/56) 和19.64%(11/56);中位生存期为11.6个月。A组患者术中出现气胸8例,肺压缩小于30%,经保守治疗好转;未见粒子迁移,白细胞减少及放射性肺炎并发症。B组患者化疗后骨髓抑制发生率为47.2%,发生恶心、呕吐42例(75.0%),腹泻9例(16.1%),脱发51例(91%),缓解率为70%。结论:CT导向下^(125)I植入治疗局部晚期非小细胞肺癌具有创伤小,并发症少,短期内降低肿瘤负荷,提高近期疗效,优于全身化疗,是治疗肺癌安全、可行、有效的治疗方法。
Objective： To evaluate the clinical significance of CT-guided percutaneous embedding of ^125I particles for the locally advanced non-small-cell lung cancer. Methods： From July 2006 to July 2007, 112 patients with non-small-cell lung cancer were randomized into two groups. Fifty-six patients received CT-guided percutaneous embedding of ^125I particles（GroupA）. Another 56 cases treated by first line chemotherapy were selected as control group（GroupB）. Results： All the patients of group A accepted implantatin operation successfully and were followedup for 2-18months . Complete response （CR） was shown in 8 cases, partial response （PR） in 32 cases, no change （NC） in 11 cases and progressive disease （PD） in 5 patients. The total response rate （ CR ＋ PR） was 71.43 %. The median survial time of group A was 14.6 months. The 1-year and 2-year survial rates were 67.86% （38/56） and 26.79% （15/56） respectively. The total response rate（ CR ＋ PR） of group B was 42.86%. The median survial period was 11.6 months. The 1-year and 2-year survial rates were 57.14% （32/56） and 19.64% （11/56） respectively. Pneumothorax occurred in 8 cases of group A during operation which was improved after conservative treatment and the lung compression rate was lower than 30% . Mobility of particles, leukopenia and radiation pneumonitis were not observed in＇group A. In group B, myelosuppression rate was 47.2%. Nausea and vomi- ting occurred in 42 cases （75.0%） , diarrhea in 9 cases （ 16.1% ） and alopecia in 51 cases （91% ）. Response rate was 70%. Conclusion： CT guided ^125I particle implantation is beneficial in reducing tumor load of locally advanced non-small-cell lung cancer in short period with small trauma and fewer complication. It is a safe, effective way to treat lung cancer.
出处
《肿瘤预防与治疗》
2009年第4期392-394,共3页
Journal of Cancer Control And Treatment
关键词
CT导引
肺癌
^125I粒子植入
化疗
CT-guided
Lung Cancer
^125I Particle Implantation
Chemotherapy
