CAJ | 학술논문

目的比较125I粒子组织间植入和外放疗分别联合PC方案(紫杉醇联合顺铂)化疗治疗非小胞肺癌的疗效与安全性.方法将87例非小细胞肺癌患者分为两组,观察组44例接受125I放射性粒子植入后联合同步PC方案化疗,对照组43例接受外放疗同步PC方案化疗.结果观察组和对照组有效率分别为88.63％和69.77％,差异有统计学意义(P=0.030)；局部控制率分别为97.72％和88.37％,差异无统计学意义(P=0.085).主要不良反应:研究组为气胸(5例,其中1例为大量气胸)、血胸(1例),未发现有针道种植转移的患者.对照组主要不良反应为放射性肺炎(17例)、肺间质纤维化(5例)、呼吸衰竭(2例)、放射性食管炎(11例)、放射性心脏损伤(2例).血液学毒性两组比较差异无统计学意义,但研究组发生率较低.结论放射线125I粒子组织间植入联合同步PC方案化疗相对于外照射联合同步PC方案化疗治疗非小细胞肺癌患者具有更好的有效率和安全性,可作为非小细胞肺癌的一种有效而安全的治疗手段.
목적 비교125I입자조직간식입화외방료분별연합PC방안(자삼순연합순박)화료치료비소포폐암적료효여안전성.방법장87례비소세포폐암환자분위량조,관찰조44례접수125I방사성입자식입후연합동보PC방안화료,대조조43례접수외방료동보PC방안화료.결과 관찰조화대조조유효솔분별위88.63％화69.77％,차이유통계학의의(P=0.030)；국부공제솔분별위97.72％화88.37％,차이무통계학의의(P=0.085).주요불량반응:연구조위기흉(5례,기중1례위대량기흉)、혈흉(1례),미발현유침도충식전이적환자.대조조주요불량반응위방사성폐염(17례)、폐간질섬유화(5례)、호흡쇠갈(2례)、방사성식관염(11례)、방사성심장손상(2례).혈액학독성량조비교차이무통계학의의,단연구조발생솔교저.결론 방사선125I입자조직간식입연합동보PC방안화료상대우외조사연합동보PC방안화료치료비소세포폐암환자구유경호적유효솔화안전성,가작위비소세포폐암적일충유효이안전적치료수단.
Objective To evaluate the efficacy and toxicity of PC (paclitaxel combined with cisplatin) regimen chemotherapy respectively combined with implantation of 125 I seed by CT-guided percutaneous instersticial brachytherapy and external beam radiotherapy in non-small cell lung cancer (NSCLC).Methods Eighty-seven patients with NSCLC were enrolled in a randomized,two-armed clinical trial.Among these patients,44 patients (the observed group) received a concurrent treatment of PC regimen combining with CT-guided percutaneous 125I seed instersticial implantation,while 43 patients (the control group) received concurrent PC regimen chemotherapy combining with external beam radiotherapy.Results The response rate (RR) was 88.63％ in the observed group and 69.77％ in the control group,there was significant difference (P =0.030).The disease control rate (DCR) was 97.72％ in the observed group and 88.37％ in the control group,there was significant difference (P =0.085).The complications in the observed group included 5 cases of pneumothorax and 4 cases of hemothorax,without implantation metastasis at the needle passage.The complications in the control group included 17 cases of radiation pneumonia,5 cases of radiation pulmonary interstitial fibrosis,2 cases of respiratory failure,11 cases of radiation esophagitis,2 cases of radiation cardiac trauma.The incidence of myelosuppression was lower in the observed group than that in the control group,but there was no significant difference.Conclusions Combined CT-guided 125I radioactive seed implantation and PC regimen chemotherapy are effective and safe for treating NCSLC compared with concurrent PC regimen chemotherapy combining with external beam radiotherapy,and can be an effective and safe scheme for NSCLC.