^(125)I粒子植入在原发性肺癌治疗后复发患者中的近期和远期疗效及影响因素

Short-and long-term efficacy and influencing factors of^(125)I seed implantation for relapsed primary lung cancer

目的分析^(125)I粒子植入在原发性肺癌治疗后复发患者中的近期和远期疗效及影响因素。方法回顾性纳入行^(125)I粒子植入治疗的40例原发性肺癌治疗后复发患者。术后3个月完善CT检查,以评价近期疗效,将患者分为有效组(完全缓解和部分缓解)和无效组(疾病进展和病情稳定)。通过电话随访和电子病历查询,记录患者死亡情况和生存时间。采用logistic回归分析和Cox回归分析,分别评价近期疗效和远期生存情况的影响因素。结果40例患者中,有效组16例,无效组24例。多因素logistic回归分析提示,术后100%靶体积受照剂量(OR=0.944,95%CI:0.898~0.992,P=0.023)为患者近期疗效的独立影响因素。中位随访时间为12个月,最终患者死亡25例,生存10例,失访5例。多因素Cox回归分析提示,肿瘤最长径(HR=1.310,95%CI:1.010~1.698,P=0.042)为患者远期生存情况的独立影响因素。结论原发性肺癌治疗后复发患者^(125)I粒子植入治疗后近期和远期疗效均有改善,术后100%靶体积受照剂量为近期疗效的独立影响因素,肿瘤最长径为远期生存情况的独立影响因素。

Objective To analyze the short-and long-term efficacy and influencing factors of^(125)I seed implantation for relapsed primary lung cancer.Methods Forty patients who received^(125)I seed implantation for relapsed primary lung cancer were retrospectively included.CT examination was performed 3 months after surgery to evaluate the short-term efficacy.Patients were divided into the effective group(complete remission and partial remission)or the ineffective group(stable disease and progressive disease).Patient deaths and survival times were documented through telephone or electronic case inquiry.Factors influencing short-term efficacy and long-term survival were evaluated using logistic and Cox regression analysis,respectively.Results Among the 40 patients,16 cases were effective and 24 were ineffective.Multivariate logistic regression analysis indicated that postoperative dose delivered to 100%gross tumor volume(D100)(OR=0.944,95%CI:0.898-0.992,P=0.023)was an independent factor for short-term efficacy.The median duration of follow-up was 12 months.Twenty-five patients died,ten survived,and five were lost to follow-up.Multivariate Cox regression analysis suggested that the longest tumor diameter(HR=1.310,95%CI:1.010-1.698,P=0.042)was an independent factor for long-term survival.Conclusion^(125)I seed implantation has improved the short-and long-term efficacy of treatment for relapsed primary lung cancer.Postoperative D100 is an independent factor influencing short-term efficacy,and longest tumor diameter is an independent factor for long-term survival,in patients receiving^(125)I seed implantation for relapsed primary lung cancer.