放射性^(125)I粒子植入联合紫杉醇治疗非小细胞肺癌的随访研究

Follow-up study of radioactive ^(125)I seed implantation combined with paclitaxel in treatment of non-small cell lung cancer

目的评价放射性^(125)I粒子植入联合紫杉醇(PTX)化疗治疗老年非小细胞肺癌的疗效和安全性。方法回顾性分析2013年6月至2014年8月该院收治的35例非小细胞肺癌患者的临床资料,其中12例仅接受肺肿瘤放射性^(125)I粒子植入治疗(A组),10例接受放射性^(125)I粒子植入治疗后再行PTX联合顺铂(TP方案)化疗(B组),13例仅接受TP方案化疗(C组)。以接受化疗21d为1个评价周期,每1个周期评价不良反应,每2个周期评价疗效。结果 35例患者随访6个月,均可评价不良反应,34例可评价近期疗效。A组未出现明显不良反应,B组、C组的主要不良反应为骨髓抑制和消化道反应,差异均无统计学意义(P>0.05)。化疗4个周期后,A组和B组的有效率分别为66.7%、80.0%,临床获益率分别为83.3%、90.0%,均高于C组的23.1%和53.8%,差异均有统计学意义(P<0.05)。结论放射性^(125)I粒子植入治疗与PTX联合放射性^(125)I粒子植入治疗老年早期非小细胞肺癌,均较单纯PTX化疗的有效率、临床获益率高,且安全、微创、不良反应轻,可有效提高患者的生活质量。

Objective To evaluate the efficacy and safety of radioactive -（125）I seed implantation combined with paclitaxel（PTX）for treating senile non-small cell lung cancer（NSCLC）.Methods The clinical data in 35 patients with NSCLC in our hospital from June 2013 to August 2014 were retrospectively analyzed,including 12 cases receiving the lung tumor radioactive -（125）I seed implantation therapy（group A）,10 cases treated with PTX combined with cisplatin（TP scheme）after receiving radioactive -（125）I seed implantation therapy（group B）and 13 cases only conducted TP scheme（group C）.The 21 dchemotherapy was a evaluation cycle.The adverse reactions were evaluated after 1cycle and the curative efficacy was evaluated after 2cycles.Results Thirty-five cases were followed up for 6months.The adverse reactions could be evaluated in all the cases.The short-term efficacy could be evaluated in 34 cases.The group A had no obvious adverse reactions,the main adverse reactions in the group B and C were bone marrow suppression and digestive tract reactions without statistically significant differences（P〈0.05）.The effective rates after 4cycles of chemotherapy in the group A and B were 66.7% and 80.0%,the clinical benefit rates were 83.3% and 90.0%respectively,which were higher than 23.1% and 53.8% in the group C respectively,the differences were statistically significant（P〈0.05）.Conclusion Radioactive-（125）I seed implantation therapy and PTX combined with radioactive -（125）I seed implantation for treating senile early NSCLC are superior to the simple PTX chemotherapy,which have high effective rate and benefit rate,safety,mini-invasion and mild adverse reactions,and can increase the patient′s living quality.