摘要
目的 探讨3D打印模板辅助^(125)I粒子植入联合射频消融治疗中晚期肺癌患者的临床效果。方法 选取2020年6月至2022年6月于杭州市肿瘤医院和树兰(杭州)医院就诊的中晚期肺癌患者共60例。其中30例患者采用单纯射频消融治疗,为单纯组;另30例患者采用3D打印模板辅助^(125)I粒子植入联合射频消融治疗,为联合组。比较两组患者治疗3个月后临床疗效;评估两组患者治疗前和治疗3个月后卡诺夫斯基健康状况量表(KPS)评分;对比两组患者治疗前和治疗3个月后血常规指标(RBC、WBC和Hb)水平、血清肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19片段抗原21-1(CYFRA21-1)和鳞状细胞癌抗原(SCC-Ag)]水平和肿瘤消融靶区体积变化;观察两组患者1年内生存情况和治疗后不良反应发生情况。结果 治疗3个月后,联合组患者的客观缓解率和疾病控制率均高于单纯组(83.33%比56.67%、93.33%比73.33%,均P<0.05);联合组KPS评分高于单纯组[(81.50±3.92)分比(78.97±3.66)分,P<0.05]。治疗3个月后,两组患者血常规指标水平比较差异均无统计学意义(均P>0.05),联合组血清CEA、CYFRA21-1、SCC-Ag水平均明显低于单纯组[(9.42±2.13)ng/L比(13.08±2.64)ng/L、(14.51±3.47)ng/L比(18.83±3.09)ng/L、(2.90±1.01)ng/L比(5.15±1.09)ng/L,均P<0.05];联合组患者肿瘤消融靶区体积小于单纯组[(53.66±15.50)cm3比(70.81±15.34)cm3,P<0.05]。联合组患者1年生存率为83.33%,显著高于单纯组的56.67%(P<0.05)。两组患者各不良反应发生情况比较差异均无统计学意义(均P>0.05)。结论 3D打印模板辅助^(125)I粒子植入联合射频消融治疗中晚期肺癌的临床效果显著,可提高患者KPS评分,降低血清肿瘤标志物水平,缩小肿瘤消融靶区体积,有效延长患者的生存期,值得临床推广应用。
Objective To investigate the clinical efficacy and safety of 3D-printed template-assisted 125I seed implantation combined with radiofrequency ablation in the treatment of advanced lung cancer.Methods Sixty patients with advanced lung cancer treated in Hangzhou Cancer Hospital and Shulan(Hang Zhou)Hospital between June 2020 and June 2022 were randomly divided into two groups with 30 cases in each group.Patients in control group were treated with radiofrequency ablation alone,and patients in study group were treated with 3D-printed template-assisted 125I seed implantation combined with radiofrequency ablation.The clinical efficacy of the two groups was compared after 3 months of treatment.The Karnofsky performance status(KPS)scores were evaluated before and after treatment.The levels of blood routine indexes(RBC,WBC,and Hb),tumor markers(CEA,CYFRA21-1,and sSCC-Ag)and the target volume of tumor ablation were compared before and after treatment.The survival within 1 year and the incidence of adverse complications were observed in the two groups.Results After 3 months of treatment,the objective response rate and disease control rateof in study group were significantly higher than those in the control group(83.33%vs.56.67%and 93.33%vs.73.33%;P<0.05);the KPS score of study group was significantly higher than that in the control group(81.50±3.92 vs.78.97±3.66;P<0.05).There were no significant differences in blood routine indexes between the two groups after treatment(P>0.05),while serum levels of CEA(9.42±2.13 ng/L vs.13.08±2.64 ng/L),CYFRA21-1(14.51±3.47 ng/L vs.18.83±3.09 ng/L)and SCC-Ag(2.90±1.01 ng/L vs.5.15±1.09 ng/L)were significantly lower than those in control group(all P<0.05);the target volume of tumor ablation was significantly lower in study group than that in the control group(53.66±15.50 cm3 vs.70.81±15.34 cm3,P<0.05).The 1-year survival rate of patients in the study group was significantly higher than that of the control group(83.33%vs.56.67%,P<0.05).There was no significant difference in the incidence of adverse complications between the two groups(P>0.05).Conclusion The clinical efficacy of 3D-printing template-assisted 125I seed implantation combined with radiofrequency ablation is better than that of radiofrequency ablation alone in the treatment of advanced lung cancer;it can better improve the KPS score of patients,reduce the serum tumor markers levels and shrunk tumor ablation target volume,and effectively prolong the survival of patients without increasing incidence of adverse reactions,which is worthy of clinical application.
作者
陶志刚
曹国洪
王加奇
周健
TAO Zhigang;CAO Guohong;WANG Jiaqi;ZHOU Jian(Department of Radiology,Hangzhou Cancer Hospital,Hangzhou 310002,China;不详)
出处
《浙江医学》
CAS
2023年第5期493-497,503,共6页
Zhejiang Medical Journal
基金
杭州市医药卫生科技项目(A20200595)。
