^(125)I粒子肿瘤内植入联合易瑞沙治疗老年周围性肺腺癌的临床观察

Radioactive seed ^(125)I implantation plus iressa in treatment of elderly patients with peripheral lung adenocarcinoma

为了探讨125I粒子肿瘤内植入联合易瑞沙治疗老年周围性肺腺癌的临床价值,对26例患者行CT导引下经皮肺穿刺活检,均确诊为肺腺癌,其中8例为肺泡细胞癌,Ⅰ期6例,Ⅱ期4例,Ⅲ期16例。所有患者均拒绝或无法手术,接受口服易瑞沙联合经皮穿刺CT导引下肿瘤内植入125I粒子治疗。结果CR10例,PR8例,SD5例,PD3例,有效率为69%(18/26),疾病控制率为88%(23/26)。73%(19/26)患者纳差、乏力明显改善,81%(21/26)患者KPS评分改善,治疗前后差异有统计学意义,χ2=7.38,P=0.025。治疗过程中毒副反应轻微且可逆,主要为皮疹(69%,18/26)和腹泻(31%,8/26)。初步研究结果提示,125I粒子肿瘤内植入联合易瑞沙治疗老年周围性肺腺癌疗效好,创伤小,不良反应低。

The objective of this study was to investigate the clinical value of radioactive seed ^125I implantation plus iressa in the treatment of elderly patients with peripheral lung adenocarcinoma. Twenty-six patients were corn firmed as peripheral lung adenocarcinoma by CT guided biopsy of lung lesions,of them,8 cases were bronchoalveolar caicinoma, 6 in the stage Ⅰ ,4 in the stage Ⅱ , 16 in the stage Ⅲ. All the patients underwent the treatment of CT guided radioactive seed ^125I implantation plus iressa. The tumor controlling situation was CR in 10 cases, PR in 8 cases, SDin 5 cases, PD in 3 cases and the total effective rate was 69% （18/26） and the total control rate was 88% （23/26）. The alleviative rate of clinical symptoms was above 73%. Adverse events （AEs） were generally mild and reversible. KPS grading of 81% （21/26） patients improved. Between before and after the treatment, there was a significant difference,χ^2=7. 38, P=0. 025. The most frequent AEs were rash （69%,18/26） and diarrher （31%, 8/26）. In conclusion, CT guided radioactive seed ^125I implantation plus iressa in the treatment of the elderly patients with peripheral lung adenocarcinoma has good clinical effects with minimal damage and few complications.