CAJ | 학술논문

目的评价~(125)I粒子植入联合(吉西他滨+顺铂GP)方案治疗老年非小细胞肺癌(NSCLC)的可行性、安全性及疗效.方法 46例NSCLC中,初治26例,复治20例.均行CT引导下瘤体内~(125)I粒子植入后3～5 d予GP方案:吉西他滨1 000 ms/m2,静脉滴注30 min,第1、8、15天;顺铂30 ms/m2,静脉滴注,第1～3天;重组人血管内皮抑素7.5 ms/m2,静脉滴注3～4 h,第1～14天;28 d为1个疗程.粒子植入后2个月(即化疗2个疗程后)进行近期疗效及不良反应评价.结果 ~(125)I粒子植入2个月后,46例患者全部可评价疗效.全组完全缓解(CR)12例,部分缓解(PR)24例,稳定(SD)6例,进展(PD)4例,总有效率78.3%.其中初治组26例中,CR 7例,PR 15例,SD 3例,PD 1例,有效率84.6%;复治组20例中,CR 5例,PR 9例,SD 3例,PD 3例,有效率70.0%.结论 ~(125)I粒子植入联合GP方案治疗对不能手术的老年NSCLC患者是一种安全、可行、有效的治疗方法.
목적 평개~(125)I입자식입연합(길서타빈+순박GP)방안치료노년비소세포폐암(NSCLC)적가행성、안전성급료효.방법 46례NSCLC중,초치26례,복치20례.균행CT인도하류체내~(125)I입자식입후3～5 d여GP방안:길서타빈1 000 ms/m2,정맥적주30 min,제1、8、15천;순박30 ms/m2,정맥적주,제1～3천;중조인혈관내피억소7.5 ms/m2,정맥적주3～4 h,제1～14천;28 d위1개료정.입자식입후2개월(즉화료2개료정후)진행근기료효급불량반응평개.결과 ~(125)I입자식입2개월후,46례환자전부가평개료효.전조완전완해(CR)12례,부분완해(PR)24례,은정(SD)6례,진전(PD)4례,총유효솔78.3%.기중초치조26례중,CR 7례,PR 15례,SD 3례,PD 1례,유효솔84.6%;복치조20례중,CR 5례,PR 9례,SD 3례,PD 3례,유효솔70.0%.결론 ~(125)I입자식입연합GP방안치료대불능수술적노년NSCLC환자시일충안전、가행、유효적치료방법.
Objective To assess the feasibility, safety and curative effect of permanent implantation of ~(125)I seeds combined with GP scheme chemotherapy for the treatment of non-small cell lung carcinoma (NSCLC) in aged patients. Methods CT-guided permanent implantation of ~(125)I seeds combined with GP scheme chemotherapy was performed in 46 patients with NSCLC, of whom 26 received primary treatment and 20 underwent renewed treatment. During the procedure, ~(125)I seeds were embedded into the tumor in all the patients. Three to five days after the implantation, GP scheme chemotherapy started. GEM (1 000 mg/m~2) was given (intravenously dripping for 30 min.) on the 1st, 8th and 15th day; DDP (30 mg/m~2) was employed on the 1st, 2nd and 3rd day, and recombinant human endostatin (Endostar, 7.5 mg/m~2) was administered (intravenously dripping for 3-4 hours) from the 1st to the 14th day. Every 28 days completed one treatment course. Two months after ~(125)I seed implantation, at this time the patient had received two courses of treatment, the short-term effect and the toxic side-effect were evaluated. Results Two months after the ~(125)I particles were embedded in the tumor, all the 46 cases were able to be evaluate for the curative effect. Of 46 patients, complete relief (CR) was seen in 12, partial relief (PR) in 24, stable (SD) in 6 and progression (PD) in 4, with an effective rate of 78.26%. Of 26 patients in the primary treatment group, CR was obtained in 7, PR in 15, SD in 3 and PD in 1, with an effective rate of 84.6%. Of 20 patients in the renewed treatment group, CR was seen in 5, PR in 9, SD in 3 and PD in 3, with an effective rate of 70.0%. Conclusion Permanent implantation of ~(125)I seeds combined with GP scheme chemotherapy is an effective, safe and feasible treatment for NSCLC in aged patients.