摘要
目的研究支气管动脉灌注化疗+栓塞术联合放射性125I粒子植入术治疗原发性肺癌的临床疗效。方法选择2009—2012年在常德市第二人民医院住院治疗的高龄及有基础疾病不能耐受手术切除的原发性肺癌患者98例,根据患者治疗方法不同分为治疗组(40例)和对照组(58例)。治疗组患者先行支气管动脉灌注化疗+栓塞术联合放射性125I粒子植入术,之后给予全身静脉化疗。对照组患者给予全身静脉化疗联合放疗。观察治疗组患者放射性125I粒子植入情况,比较两组患者临床疗效、1年累计生存率、中位生存时间及毒副作用发生情况。结果治疗组患者放射性125I粒子植入术全部成功;植入放射性125I粒子最少12粒,最多62粒,平均24.3粒;放射性125I粒子植入术后并发症为气胸、咯血及放射性粒子游走等,但症状均轻微。治疗组患者临床疗效优于对照组(u=792.000,P<0.01)。经随访,治疗组和对照组患者1年累积生存率分别为93%和61%,经log-rank检验,差异有统计学意义(χ2=7.561,P<0.01);中位生存时间分别为524 d和431 d,经log-rank检验,差异有统计学意义(χ2=6.329,P<0.05)。两组患者白细胞计数降低(χ2=0.535)、血红蛋白降低(χ2=0.034)、血小板计数降低(χ2=0.006)及恶心呕吐(χ2=0.408)发生率比较,差异无统计学意义(P>0.05)。结论支气管动脉灌注化疗+栓塞术联合放射性125I粒子植入术治疗原发性肺癌疗效较好,可有效延长患者生存时间和提高生存率,尤其适用于不愿手术或不能手术的中晚期肺癌患者。
Objective To investigate the clinical effect of bronchial arterial infusion chemotherapy and embolization combined with radioactive 125I seeds implantation on primary lung cancer. Methods A total of 98 aged inpatients with primary lung cancer that can not tolerate operation were selected in the Second People＇s Hospital of Changde from 2009 to 2012, and they were divided into treatment group （n = 40） and control group （n = 58 ） according to therapeutic methods. Patients of observation group were given bronchial arterial infusion chemotherapy and embolization combined with radioactive 125I seed implantation, and then were given intravenous systemic chemotherapy; patients of control group were given intravenous systemic chemotherapy combined with radiotherapy. The implantation condition of radioactive 125I seeds of treatment group was observed, clinical effect, one - year cumulative survival rate, median survival time and incidence of toxic and side effect were compared between the two groups. Results Patients of treatment group were all successfully completed the radioactive 125I seeds implantation, range at 12 to 62 seeds, average at 24. 3 seeds, and the complications including mild aerothorax, hemoptysis and migration of seeds. The clinical effect of treatment group was statistically significantly better than that of control group （ u = 792. 000, P 〈 0. 01 ）. The one - year cumulative survival rate of treatment group was 93%, that of control group was 61%, the difference was statistically significant （ log - rank χ^2 = 7. 561, P 〈 0. 01 ）. The median survival time of treatment group was 524 days, that of control group was 431 days, the difference was statistically significant （log- rank χ^2 = 6. 329, P 〈 0.01 ）. No statistically significant differences of incidence of white blood cell count decreased （ χ^2 = 0. 535 ）, hemoglobin decreased （ χ^2 = 0. 034）, blood platelet count decreased （χ^2 = 0. 006 ） or nausea and vomiting （χ^2 = 0. 408 ） was found between the two groups （P 〉 0. 05 ）. Conclusion Bronchial arterial infusion chemotherapy and embolization combined with radioactive 125I seeds implantation has better clinical effect on primary lung cancer, which can effectively lengthen the survival time and improve the survival rate, especially in middle - late stage lung cancer patients that do not want to or can not receive surgery.
出处
《实用心脑肺血管病杂志》
2015年第4期98-101,共4页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
常德市科学技术研究与开发资金项目(2012SK12):实体性肿瘤靶向治疗临床研究
关键词
肺肿瘤
支气管动脉
灌注化疗
放射性125I粒子
栓塞
Lung neoplasms
Bronchial arteries
Infusion chemotherapy
Radioactive 125I seeds
Embolization
