微波凝固联合^(131)I肿瘤细胞核人鼠嵌合单克隆抗体注射治疗非小细胞肺癌的疗效分析与安全性评价

Efficacy analysis and safety evaluation of microwave coagulation combined with ^(131)I-chTNT in treatment of non small cell lung cancer

目的探讨CT引导下经皮穿刺微波凝固治疗(PMCT)联合131I肿瘤细胞核人鼠嵌合单克隆抗体注射液(131I-chTNT)治疗局部中晚期老年非小细胞肺癌(NSCLC)的临床疗效及安全性。方法 78例Ⅲb~Ⅳ期不可手术切除的老年NSCLC患者分成2组:对照组(37例)行化疗联合放疗;观察组(41例)行微波凝固联合131I-chTNT放射免疫治疗。对比分析2组患者的临床疗效、生存质量、不良反应发生率及生存率。结果对照组和观察组患者的治疗有效率分别为46%和68%,差异有统计学意义(P<0.05);对照组KPS评分改善率为54%,观察组为78%,差异有统计学意义(P<0.05);对照组与观察组1年生存率分别为49%和59%,中位生存时间分别为340d和389d,差异无统计学意义(P>0.05)。观察组的不良反应发生率明显比对照组低,差异有统计学意义(P<0.05)。结论微波凝固联合131I-chTNT放射免疫综合治疗不可手术切除的中晚期老年NSCLC短期疗效优于同期放化疗方案,不良反应低,患者耐受良好,是一种安全、有效的治疗方法。

Objective To observe the clinical efficacy of microwave ablation combined with 131I-chTNT radioimmunotherapy to treat non-small cell lung cancer（NSCLC）.Methods Seventy-eight patients who were pathologically confirmed with NSCLC were divided into two groups,control group（37cases）with docetaxel combined with cisplatin in the treatment;observation group（41cases）with CT-guided percutaneous microwave ablation combined with 131I-chTNT radioimmunotherapy.Results The effective rate of observation group was 68%,significantly higher than 46% of the control group.The difference was statistically significant between two groups（P0.05）;after treatment,the observation group improved more obviously,and the difference was statistically significant between two groups（P0.05）;the side effects occurred in the observation group were significantly less than those of the control group,and the difference was statistically significant between two groups（P0.05）.Conclusion The treatment of NSCLC by microwave ablation combined with 131I-chTNT radioimmunotherapy has satisfactory clinical efficacy and reliable security.