(125)^I粒子植入术联合同步放化疗治疗局部晚期非小细胞肺癌的疗效

Efficacy of (125)^I seed implantation combined with concurrent chemoradiotherapy in the treatment of locally advanced non-small cell lung cancer

目的探讨(125)^I粒子植入术联合同步放化疗治疗局部晚期非小细胞肺癌的疗效。方法共纳入106例局部晚期NSCLC患者,根据治疗方案的不同分为观察组(n=56)和对照组(n=50),对照组患者给予同步放化疗治疗,观察组患者给予(125)^I粒子植入术联合同步放化疗治疗。治疗4个疗程后比较两组近期疗效、血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)]水平和不良反应发生情况。结果观察组患者的近期疗效优于对照组(P﹤0.05)。观察组患者客观缓解率(ORR)为91.07%,明显高于对照组患者的70.00%(P﹤0.01),疾病控制率(DCR)为96.43%,高于对照组患者的84.00%(P﹤0.05)。治疗后,两组CEA、CA125、CYFRA21-1水平均低于本组治疗前(P﹤0.05),且观察组患者CEA、CA125、CYFRA21-1水平均低于对照组(P﹤0.05)。观察组患者的不良反应总发生率为51.79%,与对照组患者的50.00%无明显差异(P﹥0.05),且均为1~2级不良反应。结论(125)^I粒子植入联合同步放化疗治疗局部晚期NSCLC患者的近期疗效显著,可有效降低CEA、CA125、CYFRA21-1肿瘤标志物水平,且不良反应少,安全可控。

Objective To investigate the efficacy of (125)^I seed implantation combined with concurrent chemoradiotherapy in the treatment of locally advanced non-small cell lung cancer(NSCLC).Method A total of 106 patients with locally advanced NSCLC were included and divided into observation group(n=56)and control group(n=50)according to different treatment regimens.The patients in the control group were treated with concurrent chemoradiotherapy,and the patients in the observation group were treated with (125)^I seed implantation combined with concurrent chemoradiotherapy treatment.After 4 cycles of treatment,the short-term efficacy,serum tumor markers[carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125),cyto-keratin 19 fragment antigen 21-1(CYFRA21-1)]levels,and adverse events were compared between the two groups.Result The short-term efficacy of the observation group was better than that of the control group(P<0.05).The objective response rate(ORR)of the observation group was 91.07%,higher than 70.00%of the control group(P<0.01),and the disease control rate(DCR)was 96.43%,higher than 84.00%of the control group(P<0.05).After the treatment,the levels of CEA,CA125,and CYFRA21-1 in the two groups were lower than those before the treatment(P<0.05),and the levels of CEA,CA125,and CYFRA21-1 in the observation group were lower than those in the control group(P<0.05).The total incidence of adverse events in the observation group was 51.79%,which was not significantly different from 50.00%in the control group(P>0.05),and all events were among grade 1-2.Conclusion (125)^I seed implantation combined with concurrent chemoradiotherapy has significant short-term efficacy in the treatment of locally advanced NSCLC patients,and can effectively reduce the levels of CEA,CA125,CYFRA21-1,and other tumor markers with low risk of adverse events.The combined therapy is safe and controllable.