放射性^(125)I粒子植入联合GP方案治疗中晚期非小细胞肺癌的效果观察

Effect of radioactive ^(125)I seeds implantation combined with GP regimen in the treatment of advanced non-small cell lung cancer

目的探讨放射性^(125)I粒子植入联合GP方案(吉西他滨+顺铂)在中晚期非小细胞肺癌中的治疗价值。方法前瞻性选取沧州市人民医院2017年12月至2018年7月收治的中晚期非小细胞肺癌患者94例,根据随机数字表法分成对照组与观察组各47例。对照组采用GP方案化疗,观察组采用放射性^(125)I粒子植入联合GP方案治疗,均接受6个周期化疗。比较两组治疗效果,分别在治疗前、疗程结束时采血检测血清肿瘤标志物水平,包括癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白片段21-1(CYFRA21-1)、鳞状细胞癌抗原(SccAg),并记录毒副作用发生率。结果观察组总缓解率为61.70%,高于对照组的40.43%,差异有统计学意义(P <0.05)。两组治疗后血清NSE、CEA、CYFRA21-1、SccAg水平低于治疗前,且观察组低于对照组,差异有统计学意义(P <0.05)。两组血小板减少、咯血、气胸、血红蛋白减少、恶心呕吐、中性粒细胞减少发生率比较无统计学意义(P> 0.05)。结论与单纯GP化疗方案相比,放射性^(125)I粒子植入联合GP方案能提高中晚期非小细胞肺癌患者的临床疗效,进一步改善血清肿瘤标志物水平,且未增加不良反应发生率,临床推广价值较高。

Objective To investigate the value of radioactive 125 I seed implantation combined with GP regimen(gemcitabine+cisplatin)in the treatment of advanced non-small cell lung cancer(NSCLC).Methods Ninety-four patients with advanced non-small cell lung cancer(NSCLC)admitted to our hospital from December 2017 to July 2018 were divided into control group and observation group with 47 cases in each group according to random number table method.The control group was treated with chemotherapy with GP regimen,while the observation group was treated with radioactive 125 I seed implantation combined with GP regimen.All patients received 6 cycles of chemotherapy.The therapeutic effects of the two groups were compared,and the serum tumor markers were detected before and after treatment respectively.These include carcinoembryonic antigen(CEA),neuron specific enolase(NSE),cytokeratin fragment 21-1(CYFRA21-1),squamous cell carcinoma antigen(SccAg).And record the incidence of side effects.Results The total remission rate in the observation group was 61.70%,higher than that in the control group(40.43%),the difference was statistically significant(P<0.05).The serum levels of NSE,CEA,CYFRA21-1 and SccAg in the two groups after treatment were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of thrombocytopenia,hemoptysis,pneumothorax,hemoglobin reduction,nausea and vomiting,and neutropenia between the two groups(P>0.05).Conclusion Compared with GP chemotherapy alone,radioactive 125 I seed implantation combined with GP regimen can improve the clinical efficacy of advanced non-small cell lung cancer patients,further improve the level of serum tumor markers,and does not increase the incidence of adverse reactions,higher clinical value of promotion.