CAJ | 학술논문

目的探讨影响放射性125I粒子植入治疗非小细胞肺癌(NSCLC)近期疗效的因素.方法 141例原发性NSCLC患者实施CT引导下放射性125I粒子植入治疗,其中26例单纯粒子植入,115例粒子植入联合化疗.所有患者术后6个月行胸部CT检查,根据肿瘤大小变化进行疗效评估,并分析影响近期疗效的相关因素.结果 (1)粒子植入后完全缓解37例,部分缓解93例,有效率92.2％.(2)单因素分析显示:肿瘤分型(F =5.162,P=0.023)、覆盖100％肿瘤瘤体剂量(D100)(F=100.713,P=0.000)、治疗模式(F=16.205,P=0.000)对局部疗效有影响.单因素logistic回归分析显示:D100、治疗模式、肿瘤分型均为影响局部疗效的独立因素.(3)单因素分析显示:肿瘤分型(x2=7.313,P=0.007)、D100(x2=71.6,P=0.000)、治疗模式(x2=20.5,P=0.000)均为影响晚期NSCLC粒子植入治疗效果的重要因素.所有患者治疗期间均未发生相关严重并发症,且与近期疗效无明显相关(P＞0.05).结论 CT引导下放射性125I粒子植入治疗NSCLC是一种安全、有效的治疗方法,D100为影响近期疗效最主要的因素.
목적 탐토영향방사성125I입자식입치료비소세포폐암(NSCLC)근기료효적인소.방법 141례원발성NSCLC환자실시CT인도하방사성125I입자식입치료,기중26례단순입자식입,115례입자식입연합화료.소유환자술후6개월행흉부CT검사,근거종류대소변화진행료효평고,병분석영향근기료효적상관인소.결과 (1)입자식입후완전완해37례,부분완해93례,유효솔92.2％.(2)단인소분석현시:종류분형(F =5.162,P=0.023)、복개100％종류류체제량(D100)(F=100.713,P=0.000)、치료모식(F=16.205,P=0.000)대국부료효유영향.단인소logistic회귀분석현시:D100、치료모식、종류분형균위영향국부료효적독립인소.(3)단인소분석현시:종류분형(x2=7.313,P=0.007)、D100(x2=71.6,P=0.000)、치료모식(x2=20.5,P=0.000)균위영향만기NSCLC입자식입치료효과적중요인소.소유환자치료기간균미발생상관엄중병발증,차여근기료효무명현상관(P＞0.05).결론 CT인도하방사성125I입자식입치료NSCLC시일충안전、유효적치료방법,D100위영향근기료효최주요적인소.
Objective To explore influential factors of local therapeutic effect in CT guided brachytherapy of 125I seeds for non-small-cell lung carcinoma (NSCLC).Methods Totally 141 primary NSCLC patients diagnosed by bronchoscope or puncture biopsy were treated with CT guided 125I seeds implantation treatment from 2003 January to 2005 January.Among them,26 patients were treated with seeds implantation only and remaining 115 combined with chemical therapy.Preplans were performed by using treatment planning system before the implantation.We took the implantation with the prescription dose of 80-110 Gy,1 seed per 1 cm3,under the guide of computed tomography.Six months after implantation treatment,CT graphs were taken to evaluate the therapeutic effect.Results All the patients were survival until 6 months after implantation,and 37 were complete remission,93 were partial remissions.The effective rate was 92.2％.Among all the observed factors,pathologic type (F =5.162,P =0.023),dose of cover 100％ tumor(D100) (F =100.713,P =0.000) and treatment methods (F =16.205,P =0.000) were the independent influent factors (P ＜ 0.05).Among these,D100 was the most important factor (P =0.000).Single factor analysis indicated that pathologic type (x2 =7.313,P =0.007),D100 (x2 =71.6,P =0.000)and treatment methods (x2 =20.5,P =0.000) were significant influent factors.Of all 141 cases,24 had complications during or after implantation treatment,while no severe complications were reported.There was no significant correlation between complication and local therapeutic effect (P ＞ 0.05).Conclusion CT guided implantation of 125I seeds for lung cancer has good clinical effects and few complications.D100 is the most important factor to influence the local therapeutic effect.Implantation treatment combined with chemotherapy is an ideal measure for NSCLC treatment.