支气管动脉灌注化疗栓塞联合^(125)I粒子植入治疗局部晚期非小细胞肺癌

Bronchial artery chemoembolization combined with ^(125)I seed implantation for locally advanced non-small cell lung cancer

目的前瞻性研究支气管动脉灌注化疗栓塞(BACE)联合放射性^(125)I粒子组织间植入治疗局部晚期非小细胞肺癌(LANSCLC)的临床疗效。方法将入选的90例患者随机分为两组:对研究组45例患者采用联合BACE(经支气管动脉GP方案局部化疗+微球栓塞)+^(125)I粒子植入,对照组45例患者采用静脉GP方案化疗+三维适形放疗。比较两组患者的近期疗效、生存率及不良反应等。结果治疗后3、6、12个月,研究组瘤体大小较对照组显著缩小,Karnofsky评分显著提高(P均<0.05);治疗后3、6、12个月的研究组的总有效率分别为73.33%(44/60)、78.18%(43/55)和83.33%(40/48),而对照组分别为38.46%(20/52)、53.19%(25/47)和65.85%(27/41),差异均有统计学意义(P均<0.05)。研究组和对照组1年生存率分别为84.44%(38/45)和55.56%(25/45),差异有统计学意义(χ~2=6.57,P<0.05)。两组骨髓抑制和放射性肺炎发生率差异有统计学意义(P均<0.05),胃肠道反应发生率差异无统计学意义(P>0.05)。结论 BACE联合^(125)I粒子组织间植入治疗LANSCLC有一定的疗效,且不良反应少,值得进一步推广。

Objective To prospectively study the effectiveness of bronchial artery chemoembolization（BACE）combined with ^（125）I seeds for treatment of locally advanced non-small cell lung cancer（LANSCLC）.Methods A total of 90 patients with LANSCLC were enrolled in the study,and were randomly divided into research group and control group.Patients in the research group were treated with BACE combined with ^（125）I seeds implantation,while patients in the control group received GP chemotherapy combined with three-dimensional conformal radiotherapy.The short-term effect,the survival rate and the incidence of adverse reactions were compared between the two groups.Results From 3 months after treatment,the tumour size in research group was significanytly diminished compared to control group,and Karnofsky score apparently enhanced.The overall response rates at 3,6,12 months in the research group were 73.33%（44/60）,78.18%（43/55） and 83.33%（40/48）,while in the control group were 38.46%（20/52）,53.19%（25/47）,65.85%（27/41）,and the difference between them was statistically significant（all P〈0.05）.The one-year survival rate of two group were 84.44%（38/45）and 55.56%（25/45）,respectively（χ~2=6.57,P〈0.05）.The differences of incidence rates of bone marrow and radiation pneumonia between two group were statistically significant（both P〈0.05）,while it was no statistically significant on gastrointestinal toxic reaction（P〉0.05）.Conclusion The method of BACE combined with ^（125）I seeds for treatment of LANSCLC is safe,feasible and effective.