山东医药
山東醫藥
산동의약
SHANDONG MEDICAL JOURNAL
2014年
21期
16-18,21
,共4页
癌%非小细胞肺%放射性同位素%碘%汉防己甲素%放射增敏
癌%非小細胞肺%放射性同位素%碘%漢防己甲素%放射增敏
암%비소세포폐%방사성동위소%전%한방기갑소%방사증민
carcinoma,non-small-cell lung%radioisotopes,iodine%tetrandrine%radiosensitization
目的：探讨放射性125 I粒子联合汉防己甲素（ Tet）治疗局部晚期非小细胞肺癌（ NSCLC）的疗效及安全性。方法将76例Ⅲa～Ⅲb期NSCLC患者随机分为两组各38例。两组均在CT引导下将125 I粒子植入靶区，放射处方剂量为110 Gy。观察组在植入125 I粒子当天口服Tet，连服3个月。比较两组的疗效和毒性反应。结果76例患者均顺利完成治疗。 D100（112．4±12．3）Gy，D90（148．7±22．5）Gy，平均剂量（238．9±11．6）Gy。中位随访时间为21个月，观察组和对照组治疗6个月时的总有效率分别为86．8％、65．8％，1年生存率分别为84．2％、63．2％，中位生存时间分别为26、18个月（P均＜0．05）。125I粒子植入的主要并发症为气胸及咯血，对照组出现1级晚期放射性肺损伤8例，观察组未出现晚期放射性肺损伤。结论125 I粒子联合Tet治疗局部晚期NSCLC近期疗效好、局部控制率高、患者生存率高、并发症少、无明显不良反应，值得临床应用。
目的：探討放射性125 I粒子聯閤漢防己甲素（ Tet）治療跼部晚期非小細胞肺癌（ NSCLC）的療效及安全性。方法將76例Ⅲa～Ⅲb期NSCLC患者隨機分為兩組各38例。兩組均在CT引導下將125 I粒子植入靶區，放射處方劑量為110 Gy。觀察組在植入125 I粒子噹天口服Tet，連服3箇月。比較兩組的療效和毒性反應。結果76例患者均順利完成治療。 D100（112．4±12．3）Gy，D90（148．7±22．5）Gy，平均劑量（238．9±11．6）Gy。中位隨訪時間為21箇月，觀察組和對照組治療6箇月時的總有效率分彆為86．8％、65．8％，1年生存率分彆為84．2％、63．2％，中位生存時間分彆為26、18箇月（P均＜0．05）。125I粒子植入的主要併髮癥為氣胸及咯血，對照組齣現1級晚期放射性肺損傷8例，觀察組未齣現晚期放射性肺損傷。結論125 I粒子聯閤Tet治療跼部晚期NSCLC近期療效好、跼部控製率高、患者生存率高、併髮癥少、無明顯不良反應，值得臨床應用。
목적：탐토방사성125 I입자연합한방기갑소（ Tet）치료국부만기비소세포폐암（ NSCLC）적료효급안전성。방법장76례Ⅲa～Ⅲb기NSCLC환자수궤분위량조각38례。량조균재CT인도하장125 I입자식입파구，방사처방제량위110 Gy。관찰조재식입125 I입자당천구복Tet，련복3개월。비교량조적료효화독성반응。결과76례환자균순리완성치료。 D100（112．4±12．3）Gy，D90（148．7±22．5）Gy，평균제량（238．9±11．6）Gy。중위수방시간위21개월，관찰조화대조조치료6개월시적총유효솔분별위86．8％、65．8％，1년생존솔분별위84．2％、63．2％，중위생존시간분별위26、18개월（P균＜0．05）。125I입자식입적주요병발증위기흉급각혈，대조조출현1급만기방사성폐손상8례，관찰조미출현만기방사성폐손상。결론125 I입자연합Tet치료국부만기NSCLC근기료효호、국부공제솔고、환자생존솔고、병발증소、무명현불량반응，치득림상응용。
Objective To investigate the efficacy and side-effect of tetrandrine (Tet) combined with 125I seed implan-tation in treatment of locally advanced none-small-cell lung cancer ( NSCLC) .Methods Seventy-six patients with clinical stage Ⅲa-Ⅲb NSCLC were randomly divided into two groups: the observation group and the control group , 38 in each group.All patients were treated with 125 I seed implantation guided by CT .The prescribed dose was 110 Gy.Patients in the observation group were treated with Tet 40mg 3 times per day for 3 months since 125 I seed implantation.The efficacy and toxicity of the two groups were compared .Results All 76 patients completed the seed implantation successfully .D100 was (112.4 ±12.3)Gy, D90 was (148.7 ±22.5)Gy and mean dose was (238.9 ±11.6)Gy.With the follow-up of 21 month, the total response rates of the observation group and the control group were 86 .8%and 65 .8%, 1-year survival rates were 84.2%and 63.2%, and the median survival time were 26 and 18 months respectively (all P<0.05).The major compli-cations were pneumothorax and blood sputum .Eight patients in the control group suffered 1 degree late radioactive pulmo-nary damage and none in the observation group .Conclusion Tet combined with 125 I seed implantation for locally advanced NSCLC shows good short-term effect, high local control rate, high survival rate, less complications and no obvious adverse reactions , which is worthy of clinical application .
