^(125)I粒子姑息治疗IIIB期非小细胞肺癌的近期疗效观察

Short-term Efficacy Observation on ^(125)I Palliative Care for Non-small Cell Lung Cancer in IIIB Stage

目的探讨术中植入放射性125I粒子治疗IIIB期非小细胞肺癌的近期疗效和可行性。方法对2008年4月至2010年5月期间我科术中确诊的IIIBNSCLC59例患者随机分为两组,A组:外放疗组,30例;B组:125I粒子植入组,29例。两组患者均在接受外照射治疗或125I粒子植入术后接受2～4个周期GP方案化疗。应用RECIST(实体瘤治疗疗效评价标准)判断疗效,RTOG(急性放射反应分级标准)评价放射损伤及并发症,比较两组的近期疗效(总有效率)和并发症。结果对两组患者随访超过6个月,并行影像学检查以了解肿瘤大小及评价近期疗效。两组患者半年生存率均为100%,差异无统计学意义(P>0.05)。A组和B组总有效率分别为63.3%和86.2%,差异有统计学意义(P<0.05)。A组和B组并发症发生率分别为36.4%和13.8%,差异有统计学意义(P<0.05)。结论 125I组织间永久植入姑息治疗IIIB期非小细胞肺癌具有疗效高、并发症发生率低等优点,可作为IIIB非小细胞肺癌综合治疗的方法之一。

Objective To investigate short-term efficacy and feasibility of 125I palliative care for non-small cell lung cancer（NSCLC） in ⅢB stage.Methods From April 2008 to May 2010,29 cases of NSCLC in ⅢB stage confirmed unresectable during the thoracotomy treated by intraoperative 125I brachytherapy under the TPS accurately were reviewed（Group A） ;30 cases who were identified as ⅢB NSCLC patients were treated by external radiotherapy after the silver clip labeled（Group B）.The efficacy and complications in two groups were compared and analyzed.Results The survival rate in two groups were 100%.The local control rate in 125 I group （Group A） and external radiotherapy group（Group B） were 86.2% and 63.3%,respectively.statistically significant difference was found in the local control rate between the two groups（P 0.05）.The complication rate of 125I group and external radiotherapy group were 13.8% and 36.4%,respectively.statistically significant difference was found in the complication rate between the two groups（P 0.05）.Conclusion Palliative care for NSCLC in stage ⅢB by 125I could achieve higher efficacy,lower trauma、lower complication rate than those in external radiotherapy group.It could be used as one of the methods in the treatment of non-small cell lung cancer in ⅢB stage.