表皮生长因子受体酪氨酸激酶抑制剂联合125I放射性粒子植入治疗非小细胞肺癌的效果

Effect of epidermal growth factor receptor tyrosine kinase inhibitor combined with^125I radioactive seed implantation in the treatment of non-small cell lung cancer

目的探讨表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIS)联合125I放射性粒子植入治疗非小细胞肺癌的效果。方法选取2015年6月~2017年5月湘南学院附属医院放射科收治的非小细胞肺癌(NSCLC)患者70例,根据治疗方法不同分为对照组(35例)观察组(35例),对照组患者给予EGFR-TKIS治疗,观察组在对照组基础上联合125I放射性粒子植入治疗。比较两组疗效、不良反应及生存率,同时比较两组治疗前后卡氏功能状态评分(KPS评分)。结果观察组有效率和局部控制率均高于对照组,差异有统计学意义(均P<0.05)。两组气胸、腹泻、皮肤不良反应及骨髓抑制的发生率比较,差异无统计学意义(P>0.05)。截至随访末共30个月,对照组死亡26例,观察组死亡18例。观察组1年生存率和2年生存率均高于对照组,且无进展生存时间明显高于对照组(P<0.05)。治疗3个月后观察组KPS评分显著高于对照组(P<0.05)。结论EGFR-TKIS联合125I放射性粒子植入能够提高NSCLC患者治疗效果及局部控制率,同时提高患者1、2年生存率及无进展生存期,改善治疗后患者生活质量,不增加治疗风险。

Objective To investigate the efficacy of epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKIS)combined with 125I radioactive seed implantation in the treatment of non-small cell lung cancer(NSCLC).Methods From June 2015 to May 2017,70 patients with NSCLC from Department of Radiology,Affiliated Hospital of Xiangnan University were selected.According to the different treatment methods,they were divided into the control group(35 cases)and the observation group(35 cases).The patients in the control group were treated with EGFR-TKIS,and the observation group was treated with 125I radioactive seed implantation on the basis of the control group.The curative effect,the adverse reaction and the survival rate of the two groups were compared,and the Karnofsky performance starus score(KPS score)before and after treatment was compared.Results The effective rate and local control rate in the observation group were significantly higher than those in the control group(all P<0.05).There was no significant difference in pneumothorax,diarrhea,adverse reaction of skin and the rate of bone marrow suppression between the two groups(P>0.05).Follow-up was conducted for 30 months,26 cases died in the control group and 18 cases in the observation group.The 1 year survival rate and 2 years survival rate in the observation group were significantly higher than those in the control group(P<0.05).The non-progression survival time was significantly higher than that in the control group(P<0.05).After 3 months of treatment,the Karlman score in the observation group was significantly higher than that in the control group(P<0.05).Conclusion EGFR-TKIS combined with 125I radioactive seed implantation can improve the therapeutic effect and local control rate of NSCLC patients,improve the 1 year and 2 years survival rate and progression-free survival time of patients,improve the quality of life of patients after treatment,and do not increase the risk of treatment.