CT导向下125I粒子植入联合化疗对难治性复发性盆腔恶性肿瘤短期疗效、血清肿瘤标志物及预后的影响

Effect of CT-guided 125I Seed Implantation combined with Chemotherapy on Short-term Efficacy,Serum Tumor Markers and Prognosis of Refractory and Recurrent Pelvic Malignant Tumors

目的探讨CT导向下125I粒子植入联合化疗治疗难治性复发性盆腔恶性肿瘤的短期疗效及对患者肿瘤标志物指标变化及预后影响。方法随机纳入60例难治性复发性盆腔恶性肿瘤患者,随机分为对照组(n=30)与研究组(n=30),对照组患者予以单纯CT导向下125I粒子植入治疗,研究组患者予以CT导向下125I粒子植入联合化疗。对比分析2组患者短期疗效、患者肿瘤标志物指标变化及预后情况。结果研究组患者治疗后客观有效率66.67%、治疗获益率86.67%;对照组患者治疗后客观有效率60.00%、治疗获益率83.33%;2组患者治疗后客观有效率对比无明显差异(χ^2=0.287,P>0.05),治疗获益率亦无明显差异(χ^2=0.131,P>0.05)。研究组患者术后1个月CA125、CEA与AFP指标水平相比对照组明显更低(t=24.429、19.105、20.296,P<0.05);2组患者治疗及随访均未见严重并发症发生。研究组肿瘤无进展时间相比对照组明显更长(t=5.224,P<0.05);研究组患者肿瘤复发率相比对照组明显更低(χ^2=4.286,P<0.05)。结论单纯125I粒子植入治疗或125I粒子植入联合化疗在难治性复发性盆腔恶性肿瘤治疗中的效果明确,对于可接受化疗的患者,选择125I粒子植入联合化疗可延长患者的肿瘤无进展生存时间。

Objective To investigate the short-term efficacy of CT-guided 125I seed implantation combined with chemotherapy in patients with refractory and recurrent pelvic malignant tumors,the changes of tumor markers and prognosis.Methods 60 patients with refractory and recurrent pelvic malignant tumors were randomly divided into the control group(n=30)and the research group(n=30).The patients in the control group were treated with CT-guided 125I seed implantation alone,and the patients in the study group were treated with CT-guided 125I seed implantation combined with chemotherapy.The short-term efficacy,changes of tumor markers and prognosis of the 2 groups were compared and analyzed.Results After treatment,the objective effective rate was 66.67%in the study group and 86.67%in the treatment benefit rate;after treatment,the objective effective rate was 60.00%in the control group and 83.33%in the treatment benefit rate;after treatment,there was no significant difference in the objective effective rate between the 2 groups(χ^2=0.287,P>0.05);after treatment,there was no significant difference in the treatment benefit rate between the 2 groups(χ^2=0.287,P>0.05).=The levels of CA125,CEA and AFP in the study group were significantly lower than those of the control group one month after operation(t=24.429,19.105,20.296,P<0.05);there were no serious complications in the treatment and follow-up of the 2 groups;the time of tumor progression in the study group was significantly shorter than that in the control group(t=5.224,P<0.05);The recurrence rate of tumors was significantly lower than that of the control group(χ^2=4.286,P<0.05).Conclusion The effect of 125I seed implantation alone or 125I seed implantation combined with chemotherapy in the treatment of refractory recurrent pelvic malignant tumors is clear.For patients who can receive chemotherapy treatment,the choice of 125I seed implantation combined with chemotherapy can prolong the long-term progression-free time of tumors.