摘要
目的探讨CT引导下碘125(125 I)粒子植入联合化疗对晚期非小细胞肺癌(NSCLC)的远期疗效及影响因素。方法回顾性分析2015年1月至2016年2月于该院行125 I粒子植入的35例NSCLC患者的相关资料,对可能影响患者预后的临床特征进行单因素及多因素分析。结果35例NSCLC患者植入125 I粒子20~150粒,平均植入77.42粒,植入完毕后立即复查胸部CT,显示粒子全部植入到位,成功率为100%。患者术后2个月完全缓解(CR)14例,部分缓解(PR)15例,有效率为82.86%;术后4个月CR 16例,PR 16例,有效率为91.43%;术后6个月CR 16例,PR 15例,有效率为88.57%。术后1、2、3年生存率分别为77.14%、34.29%、22.86%,术后1、2、3年局部控制率分别为91.43%、85.71%、80.00%。中位生存时间21.62个月,中位局部控制时间为32.24个月。单因素分析显示,TNM分期、吸烟史、血红蛋白水平、肿瘤直径、病理类型、联合化疗次数为影响患者预后的主要因素(P<0.05),进一步多因素分析发现TNM分期、血红蛋白水平、肿瘤直径、联合化疗次数是影响患者的独立预后因素。结论对于晚期肺癌患者,CT引导下125 I粒子植入是一种安全有效的治疗方式,联合化疗可改善患者预后。
Objective To research the long term effect and influential factors of CT-guided iodine-125(125 I)seed implantation combined with chemotherapy in treating advanced non-small-cell lung cancer(NSCLC).Methods The related data of 35 cases undergoing 125 I seed implantation in this hospital from January 2015 to February 2016 were retrospectively analyzed.The clinical characteristics possibly affecting the patient′s prognosis conducted the univariate and multivariate analysis.Results Thirty-five cases were implanted by 20-150125 I particles,with an average of 77.42 particles.After implantation,chest CT was re-examined immediately,showing that all the particles were implanted in right position with the success rate of 100%.The complete response(CR)at postoperative 2 months was in 14 cases,the partial response(PR)in 15 cases,and the effective rate was 82.86%;the CR at postoperative 4 months was in 16 cases,the PR in 16 cases,and the effective rate was 91.43%;the CR at postoperative 6 months was in 16 cases,the PR in 15 cases,and the effective rate was 88.57%.The postoperative 1-,2-,3-year survival rates were 77.14%,34.29%and 22.86%respectively.The postoperative 1-,2-,3-year local control rates were 91.43%,85.71%and 80.00%respectively.The median survival time was 21.62 months,and the median local control time was 32.24 months.The univariate analysis showed that TNM stage,smoking history,hemoglobin level,tumor diameter,pathological type and times of combination chemotherapy were main factors affecting the patient′s prognosis(P<0.05),the further multivariate analysis found that the TNM stage,hemoglobin level,tumor diameter and times of combination chemotherapy were the independent factor affecting the patient′s prognosis.Conclusion CT-guided 125 I seed implantation is an effective and safe treatment mode for advanced lung cancer,the combined chemotherapy can improve the prognosis of patients.
作者
熊潭有
梅同华
XIONG Tanyou;MEI Tonghua(Department of Respiration and Critical Care Medicine,First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)
出处
《重庆医学》
CAS
2020年第3期375-378,共4页
Chongqing medicine
基金
2018年重庆市科卫联合医学科研项目(2018MSXM078)
关键词
碘125
粒子植入
化疗
晚期肺癌
因素分析
iodine 125
seed implantation
chemotherapy
advanced lung cancer
factor analysis
