CT引导下^(125)I粒子植入联合支气管动脉灌注化疗栓塞治疗晚期非小细胞肺癌的效果观察

Effect observation of CT guided ^(125)I particle implantation combined with bronchial artery infusion chemotherapy and embolization in the treatment of advanced non-small cell lung cancer

目的探讨CT引导下^(125)I粒子植入联合经支气管动脉灌注化疗栓塞治疗晚期非小细胞肺癌的临床效果和安全性。方法选取2012年5月~2014年5月我科收治的70例Ⅲb~Ⅳ期非小细胞肺癌患者作为研究对象,根据治疗方法的不同分为实验组(34例)和对照组(36例)。实验组采用CT引导下^(125)I粒子植入联合经支气管动脉灌注化疗栓塞,对照组采用经支气管动脉灌注化疗栓塞,两组均以吉西他滨联合顺铂为化疗方案,于术后l、3、6个月行CT检查随访,观察两组的总有效率和不良反应发生率。结果实验组的近期总有效率为76.47%,显著高于对照组的50.00%,差异有统计学意义(P<0.05)。实验组的咯血、气胸、胸痛发生率高于对照组,差异有统计学意义(P<0.05)。两组的发热、骨髓抑制发生率比较,差异无统计学意义(P>0.05)。所有出现的不良反应均较轻,可控制。结论 ^(125)I粒子植入联合经支气管动脉灌注化疗栓塞治疗晚期非小细胞肺癌的近期效果较好,是一种安全、创伤小的方法。

Objective To explore the clinical efficacy and safety of CT guided ^125 I particle implantation combined with bronchial artery infusion chemotherapy and embolization in the treatment of advanced non-small cell lung cancer.Methods Altogether 70 cases of Ⅲb-Ⅳ stage non-small cell lung cancer who were treated in Department of Respiration in our hospital from May 2012 to May 2014 were selected and divided into the experiment group（34 cases） and the control group（36 cases） according to the different treatment methods.The experiment group was treated with CT^125 I guided particle implantation combined with bronchial artery infusion chemotherapy and embolization,and the control group was treated with bronchial artery infusion chemotherapy and embolization.For all the patients,Gemcitabine combined with Cisplatin chemotherapy was taken as the chemotherapy protocol and CT examinations and follow-up at postoperative 1,3 and 6 months were made for observation of the total effective rate and the incidence rate of adverse reactions.Results The near-term total effective rate of the experimental group was 76.47%,which was higher than that of the control group（50.00%）,with significant difference（P〈0.05）.The incidence rate of pneumothorax,hemoptysis,chest pain in the experimental group was higher than that in the control group,with significant difference（P〈0.05）.There was no significant difference between the two groups in the incidence rate of fever and bone marrow suppression（P〈0.05）.All adverse reactions were light and could be controlled.Conclusion As a safe and minimally-invasive method,application of^125 I particle implantation combined with bronchial artery infusion chemotherapy and embolization has significant near-term effect in the treatment of advanced non-small cell lung cancers.