放射性^(125)I粒子治疗晚期肺癌的疗效分析

Efficacy of ^(125)I radioactive particle implantation in treatment of advanced lung cancer

目的探讨晚期肺癌的放射性^(125)I粒子植入治疗的临床疗效。方法收集自2012年1月至2015年12月经放射性^(125)I粒子植入治疗的肺癌患者186例,分析患者的疗效及生存率。结果所有入组病例均临床随访36个月,失访5例,随访率97.31%。平均生存期16.9个月,中位生存时间18.0个月(8~23个月)。影像学随访至12个月,完全缓解(complete relief,CR)35例,部分缓解(partial relief,PR)78例,疾病稳定(stable disease,SD)32例,疾病进展(progress disease,PD)23例,死亡18例。疾病控制(CR+PR+SD)145例,12个月总体控制率77.96%,术后6例死于呼吸衰竭,12例死于全身转移、恶液质,术后最长存活时间23个月。3例粒子移位脱落至纵隔,3例出现少量气胸,经保守治疗自行吸收。5例咯血痰,经补液止血治疗后治愈。无胸腔积液、肺部感染或针道种植转移等并发症。结论放射性^(125)I粒子植入在改善晚期肺癌患者生活质量的同时,提高了患者远期生存率,是一种安全、有效的治疗方法。

Objective To evaluate the efficacy of ^125I radioactive particle implantation in treatment of advanced lung cancer. Methods One hundred and eighty six patients with advanced lung cancer were treated with ^125I radioactive particle implantation in our hospital from January 2012 to December 2012. The therapeutic efficacy and survival of patients were analyzed. Results Patients were followed up for 36 months with a follow-up rate of 97.31%. The mean survival was 16.9 months and the median survival was 18 months. According to 12-month imaging follow-up of 186 cases, 35 reached complete remission （CR） ,78 partial remission （ PR）, 32 stable disease （ SD）, 23 progress disease （ PD）, and 18 died （6 due to respiratory failure and 12 due to systematic metastases）. Total 145 cases gained disease control （CR ＋ PR ＋ SD） with an overall 12-month disease control rate of 77.96%, and the longest survival time was 23 months. After the procedure, the radioactive particles were translocated in 3 cases, minor pneumothorax occurred in 3 cases, and bloody cough was presented in 5 cases. No pleura/ effusion, pulmonary infection or implanted metastases of needle track were observed. Conclusion Implantation of ^125I radioactive particles can improve the survival and the quality of life for advance lung cancer patients.