CT引导下125I粒子组织间植入术治疗中老年肺部鳞癌41例疗效及生存分析

Curative effect and survival analysis of CT-guided 125I interstitial implantation for the treatment of 41 cases of middle-aged and elderly patients with squamous cell carcinoma of the lung

目的:探讨CT引导下125I粒子组织间植入术治疗中老年肺部鳞癌患者的疗效及术后中、远期随访结果。方法:选取2011年6月至2014年7月我院中老年肺部鳞癌患者82例,依据随机数字表法分为观察组与对照组(各41例)。对照组采取支气管动脉化疗药物灌注术,观察组采取CT引导下125I粒子组织间植入术。对比两组并发症发生率及术后6个月总有效率,比较两组术前、术后1年生存质量评分及术后1年、2年、3年、4年生存率。结果:术后6个月观察组总有效率82.93%(34/41)高于对照组60.98%(25/41),差异有统计学意义(P<0.05);术前两组健康状况、躯体疼痛、社会功能、精力等生存质量各维度评分相比,差异无统计学意义(P>0.05);术后1年,与对照组比较,观察组上述生存质量各维度评分均提高,差异有统计学意义(P<0.05);观察组术后2年、3年生存率分别为68.29%(28/41)、39.02%(16/41),均高于对照组46.34%(19/41)、17.07%(7/41),差异有统计学意义(P<0.05);观察组并发症发生率12.20%(5/41)与对照组14.63%(6/41)比较,差异无统计学意义(P>0.05)。结论:中老年肺部鳞癌患者予以CT引导下125I粒子组织间植入术治疗疗效显著,可明显延长患者生存时间,提高生存质量,且并发症较少。

Objective:To investigate the curative effect and follow-up study of CT guided interstitial implantation of 125I seeds for the treatment of forty-one cases of lung squamous cell carcinoma in middle-aged and elderly patients.Methods:According to the random number table method,eighty-two patients with lung squamous cell carcinoma from June 2011 to July 2014 in our hospital were collected and according to the method of random number table,41 cases of observation group and 41 cases of control group were divided into two groups.The control group was treated with bronchial artery chemotherapy,and the observation group received CT guided interstitial implantation of 125I seeds.We compared the incidence of complications between the two groups and the total effective rate at six months after surgery,and the preoperative and postoperative one-year quality of life scores and the one-,two-,three-,and four-year survival rates were compared between the two groups.Results:At six months after operation,the total effective rate of the observation group was 82.93%(34/41),higher than that of the control group 60.98%(25/41)(P<0.05).There were insignificant differences in score on all dimensions of quality of life,like the health condition,physical pain,social function and energy(P>0.05).After one year,compared with the control group,the quality of life in the observation group was improved in all dimensions(P<0.05).After two years and three years,the survival rates of the observation group were 68.29%(28/41)and 39.02%(16/41),which were higher than that of the control group 46.34%(19/41)and 17.07%(7/41)(P<0.05).The complication rate of the observation group was 12.20%(5/41).Compared with that of the control group 14.63%(6/41),the difference was insignificant(P>0.05).Conclusion:CT guided interstitial implantation of 125I seeds for the treatment of is an effective treatment for middle-aged and elderly patients with lung squamous cell carcinoma,which can significantly prolong the survival time and improve the quality of life of the patients with less complications.