CT引导下^(125)I放射性粒子组织间植入对非小细胞肺癌患者血清肿瘤标志物及瘤体大小的影响

Effect of CT Guided Interstitial Implantation of ^(125)I Radioactive Particles on Serum Tumor Markers and Tumor Volume in Patients with Non-small Cell Lung Cancer

目的研究CT引导下^(125)I放射性粒子组织间植入对非小细胞肺癌(NSCLC)患者血清肿瘤标志物及瘤体大小的影响。方法纳入68例需行姑息性治疗的晚期NSCLC患者,均行CT引导下^(125)I放射性粒子组织间植入治疗,评估疗效。结果术后2、3、6和12个月,患者治疗总有效率为70.59%、79.41%、67.65%和50.77%,术后12月显著低于其他月份(P<0.05);患者术前、术后2、3、6和12个月瘤体大小为29.13±5.13cm2、22.53±4.09cm^2、17.45±3.86cm^2、14.56±3.46cm^2和12.74±2.43cm^2,不同时间点比较,差异均具有统计学意义(P<0.05);术后血清CYFRA21-1、CEA、CA50和SCC-Ag呈先降低后上升(P<0.05),术后3月达最低点(P<0.05);患者无进展生存期18.2±3.1月,3年、5年生存率为41.18%和30.88%;治疗期间,患者出现气胸(19.12%)和痰中带血(5.88%)等症状,治疗后缓解。结论 CT引导下^(125)I粒子植入治疗NSCLC,可明显降低患者瘤体大小和肿瘤标志物水平,近远期疗效确切,安全可靠,是NSCLC姑息性治疗的有效方案。

Objective To study the effect of CT guided interstitial implantation of ^125I radioactive particles on serum tumor markers and tumor volume in patients with non-small cell lung cancer （NSCLC）. Methods 68 cases of patients with advanced NSCLC who needed to be treated with palliative therapy were enrolled in the study. All patients were treated with CT guided interstitial implantation of ^125I radioactive particles, and the therapeutic effect was evaluated. Results 2,3,6 and 12 months after operation, the total effective rates of treatment were 70.59% ,79.41% ,67.65% and 50.77% ,respectively. The effective rate at 12 months after operation was significantly lower in than that other time （P 〈 0.05). Before operation, 2,3,6 and 12 months after operation,the tumor size was 29.13 ± 5.13 cm^2 ,22.53 ± 4.09 cm^2, 17.45 ± 3.86 cm^2, 14.56± 3.46 cm^2和12.74 ± 2.43 cm^2 ,respectively. There were significant differences in tumor size among different time (P 〈 0.05). After operation, serum CYFRA21-1, CEA, CA50 and SCC-Ag showed an firstly decreasing and then increasing trend (P 〈 0.05), and they were the lowest at 3 months after operation (P 〈 0.05). The progression-free survival,the 3-year and 5-year survival rates of patients were 18.2 ± 3.1 months,41.18% and 30.88% ,respectively. During the treatment,there was pneumothorax(19.12%) and sputum with blood （5.88%）. Conclusion The application of CT guided ^125I seed implantation in the treatment of NSCLC can significantly reduce the tumor volume and tumor markers, safe and reliable. It is an effective treatment for NSCLC.