高频热疗联合放射性碘粒子植入治疗晚期非小细胞肺癌的临床疗效观察

Clinical Study of Radiofrequency Hyperthermia Combined with Radioactive Iodine Implantation in the Treatment of Advanced Non - small Cell Lung Cancer

【目的】探讨高频热疗联合放射性碘粒子植入治疗晚期非小细胞肺癌（NSCLC）的临床疗效。【方法】回顾性分析2013年7月至2016年7月本院收治的82例晚期NSCLC患者的临床资料,根据治疗方法的不同将其分为观察组（高频热疗联合放射性碘粒子植入治疗）和对照组（采用单纯碘粒子植入治疗）,每组各41例。碘粒子植入在CT定位引导下经皮穿刺,按粒子植入治疗计划系统将放射性碘125粒子（粒子活度为0.8 mCi）永久性植入肿瘤内予持续照射,其处方剂量约为90 Gy。观察组在植入粒子后约3~5 d进行高频热疗,隔天进行1次,每次约60 min,温度控制约42℃,连续3次。【结果】观察组总有效率为70.73%（29/41）高于对照组的48.78%（20/41）,差异具有统计学意义（χ2=4.018,P=0.043〈0.05）。观察组睡眠改善、体质量增加、食欲增加和疼痛缓解所占比例均高于对照组,差异均具有统计学意义（P〈0.05）。观察组治疗后功能状态评分好转率为46.34%（19/41）显著高于对照组的68.29%（28/41）,差异具有统计学意义（χ2=4.038,P=0.044〈0.05）。对照组和观察组均顺利完成治疗,无严重不良反应和治疗相关性病死病例。【结论】高频热疗联合放射性碘粒子植入是一种有效的治疗晚期NSCLC的方法,较单纯碘粒子植入疗效更好,且不良反应较少,易于实施,可进一步在临床推广运用。

【Objective】To investigate the clinical efficacy of radiofrequency hyperthermia combined with radioactive iodine implantation in the treatment of advanced non-small cell lung cancer （NSCLC）.【Methods】A total of 82 patients with advanced non-small cell lung cancer （NSCLC） were collected from July 2013 to July 2016, which were randomly divided into control group （n=41） and treatment group （n=41）. Iodine seeds were implanted into the tumor under the guidance of CT localization. The radioactive iodine 125 seeds （particle activity 0.8 mCi） were permanently implanted into the tumor according to the particle implantation treatment plan system. The prescription dose was about 90 Gy. In the treatment group, high frequency hyperthermia was performed about 3 days after seed implantation, once every other day for about 60 minutes, and the temperature was controlled at about 42℃ for 3 consecutive times.【Results】The total effective rate of the treatment group was 70.73% （29/41）, which was higher than that of the control group 48.78% （20/41）. The difference was statistically significant （χ2= 4.018, P=0.043〈0.05）. In the treatment group, the number of sleep improvement, weight gain, appetite increase and pain relief were higher than those in the control group, the differences were statistically significant （P〈0.05）. The improvement rate of quality of life was 46.34% in the control group and 68.29% in the treatment group, and the improvement rate of the quality of life in the treatment group was higher than that in the control group, the difference was statistically significant （χ2=4.038, P=0.044〈0.05）.【Conclusion】High frequency hyperthermia combined with radioactive iodine seed implantation is an effective method for the treatment of advanced non-small cell lung cancer, which is better than single iodine implantation and has less side effects and easy to implement. It can be further applied in clinical practice.