摘要
目的探究超声支气管镜引导下^(125)I粒子植入联合β-榄香烯脂质体对晚期纵隔型肺癌的临床疗效。方法选择于2017年9月至2021年1月在重庆市中医院治疗的120例纵隔型肺癌患者为回顾性研究对象,按治疗方法分为^(125)I粒子组、β-榄香烯组和联合治疗组,每组40例。对比三组治疗近期有效率、血清肿瘤标志物及1年肿瘤远处转移和生存情况。结果治疗后2、4、6个月,联合治疗组和^(125)I粒子组疗效显著优于β-榄香烯组,差异有统计学意义(P<0.05)。治疗后2、4、6个月,联合治疗组和^(125)I粒子组气道管径、第1秒用力呼气量容积百分比(FEV_(1)%)、6 min步行距离(6MWD)较治疗前和β-榄香烯组增加,呼吸困难指数较治疗前和β-榄香烯组降低,差异有统计学意义(P<0.05);联合治疗组血清鳞状细胞癌抗原(SCC)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA 21-1)及组织多肽抗原(TPA)较治疗前下降,差异有统计学意义(P<0.05)。联合治疗组患者治疗后4个月病灶最大横截面积较治疗前明显减小(P<0.01)。随访1年,联合组(87.5%)生存率高于^(125)I粒子组(62.5%)和β-榄香烯组(52.5%),差异有统计学意义(P<0.05)。结论超声支气管镜引导下^(125)I放射性粒子植入联合β-榄香烯治疗晚期纵隔型肺癌疗效和安全性高,耐受性好,近期预后良好,且优于单^(125)I放射性粒子植入及单用β-榄香烯治疗。β-榄香烯具有放射增敏作用,二者具有协同抗肿瘤效应。
Objective To explore the clinical effect of utrasound and bronchoscopy-guided iodine-125(^(125)I)radioactive seeds implantation combined withβ-elemene in the treatment of advanced mediastinal lung carcinoma.Methods A total of 120 patients with advanced mediastinal lung carcinoma in Chongqing Traditional Chinese Medicine Hospital from September 2017 to January 2021 were enrolled and divided randomly into^(125)I seeds group,β-elemene group and combination group(^(125)I seeds+β-elemene)according to the treatment method(n=40,each).The short-term clinical efficacy,serum tumor markers,distant metastasis and 1-year survival were compared among three groups.Results At 2,4 and 6 months after treatment,the curative effects of combination group and^(125)I seed group were significantly better than those inβ-elemene group(P<0.05).Compared with those before treatment and inβ-elemene group,the airway diameter,percentage predictive forced expiratory volume in first second(FEV_(1)%)and 6-min walking distance(6MWD)increased,and the shortness of breath index decreased significantly in combination group and^(125)I seed group at 2,4 and 6 months after treatment(P<0.05).In combination group,the serum levels of carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC)and cytokeratin 19 fragment(CYFRA 21-1)and tissue peptide antigen(TPA)were lower than those before treatment(P<0.05),and the maximum cross-sectional area of the lesions significantly reduced at 4 months after treatment(P<0.01).After 1 year follow-up,the survival rate in combination group(87.5%)was higher than that in^(125)I seeds group(62.5%)andβ-elemene group(52.5%)(P<0.05).Conclusion In the treatment of patients with advanced mediastinal lung carcinoma,ultrasound and bronchoscopy-guided^(125)I radioactive seeds implantation combined withβ-elemene is an effective,safe and feasible measure,with good short-term prognosis,which is superior to single^(125)I radioactive seeds implantation and alone use ofβ-elemene.It has been confirmed thatβ-elemene has radiosensitization effect and synergistic anti-tumor effect when combined with^(125)I radioactive seeds implantation.
作者
杨娟
伍灿
王玮
邬海桥
YANG Juan;WU Can;WANG Wei;WU Haiqiao(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Chongqing College of Traditional Chinese Medicine,Chongqing 400021,China)
出处
《中国临床研究》
CAS
2023年第6期837-843,共7页
Chinese Journal of Clinical Research
基金
重庆市自然科学基金(cstc2018jxj1130024)
重庆市中医院院级课题(cqszyy2020yjzx14)。
关键词
超声支气管镜
^(125)I放射性粒子
Β-榄香烯
晚期纵隔型肺癌
增敏
Endoscopic bronchial ultrasonography
^(125)I radioactive seeds
β-elemene
Advanced mediastinal lung carcinoma
Sensitization
