摘要
目的比较研究^(125)I放射性粒子植入联合多靶动脉减量灌注化疗治疗ⅢB期非小细胞肺癌(NSCLC)与联合静脉化疗临床疗效的差异。方法选取在2013年7月至2018年12月接受局部^(125)I放射性植入治疗联合化疗的ⅢB期NSCLC患者作为研究对象,收集患者各项临床特征资料,包括性别、年龄、体力状况、吸烟指数、病理类型、化疗方式、肿瘤体积(gross tumor volume,GTV)和100%靶区所受剂量(D100)等,接受动脉灌注化疗的患者为MAC组,接受静脉化疗的患者为SVC组。随访并行短期疗效评价和记录生存时间。结果57例SVC组CR、PR、SD和PR患者分别为1.8%(1/57)、47.4%(27/57)、45.6%(26/57)和5.3%(3/57),OR为49.1%;19例MAC组患者CR、PR、SD和PR分别为15.8%(3/19)、52.6%(10/19)、21.1%(4/19)和10.5%(2/19),OR为68.4%;两组差异有统计学意义(χ^(2)=8.192,P=0.042)。SVC组患者1、2和3年生存率分别为73.7%、26.3%和8.8%,mOS为16.3个月;MAC组患者1、2和3年生存率为84.2%、42.1%和15.8%,mOS为20.0个月;两组差异有统计学意义(χ^(2)=3.916,P=0.048)。亚组分析显示单一支气管动脉供血的患者mOS为25.0个月,多靶动脉供血患者mOS为16.8个月,两组患者OS差异明显(χ^(2)=3.944,P=0.047)。应用Cox模型单因素分析显示:GTV(HR=3.090,95%CI:1.057-8.884,P=0.036)、D100(HR=4.463,95%CI:1.261-15.798,P=0.020)、供血动脉(HR=5.885,95%CI:1.877-18.449,P=0.002)与OS显著相关,多因素分析显示:多靶动脉供血是影响OS的独立危险因素(HR=4.776,95%CI:1.265-18.039,P=0.021)。结论^(125)I放射性粒子植入治疗联合多靶动脉减量灌注化疗治疗ⅢB期NSCLC在局部病灶控制、延长生存时间方面优于联合静脉化疗,可作为治疗手段之一进行临床推广。
Objective To compare the clinical efficacy of ^(125)I radioactive seeds implantation plus multi-targeted arterial reduced-dose infusion chemotherapy(MAC)with that of ^(125)I radioactive seeds implantation plus systemic intravenous chemotherapy in treating stage ⅢB non-small cell lung cancer(NSCLC).Methods A total of 76 patients with stage ⅢB NSCLC,who received ^(125)I radioactive seeds implantation plus chemotherapy at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine of China during the period from July 2013 to December 2018,were enrolled in this study.The clinical data,including gender,age,eastern cooperative oncology group performance status(ECOG-PS)score,smoking index,pathological type,way of chemotherapy,gross tumor volume(GTV)and 100%target area radiation dose(D100),were collected.According to the approach of chemotherapy,the patients were divided into MAC group(n=19)and systemic intravenous chemotherapy group(SVC group,n=57).All the patients were followed up to evaluate the shortterm curative effect,and the survival time was recorded.Results In SVC group,complete remission(CR),partial remission(PR),stable disease(SD)and progression disease(PD)were obtained in 1.8%(1/57),47.4%(27/57),45.6%(26/57)and 5.3%(3/57)of patients respectively,with an overall response rate of 49.1%.In MAC group,CR,PR,SD and PD were seen in 15.8%(3/19),52.6%(10/19),21.1%(4/19)and 10.5%(2/19)of patients respectively,with an overall response rate of 68.4%.The differences in the above indexes between the two groups were statistically significant(χ^(2)=8.192,P=0.042).In SVC group,the 1-year,2-year and 3-year survival rates were 73.7%,26.3% and 8.8% respectively,the mean overall survival(mOS)time was 16.3 months.In MAC group,the 1-year,2-year and 3-year survival rates were 784.2%,42.1% and 15.8% respectively,the mOS time was 20.0 months.The differences between the two groups were statistically significant(χ^(2)=3.916,P=0.048).Subgroup analysis indicated that the mOS in patients whose tumor receiving
作者
李虎子
赵成
方文岩
张洪
贺斌
段振东
LI Huzi;ZHAO Cheng;FANG Wenyan;ZHANG Hong;HE Bin;DUAN Zhendong(Department of Oncology,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300192,China)
出处
《介入放射学杂志》
CSCD
北大核心
2021年第9期893-898,共6页
Journal of Interventional Radiology
关键词
支气管动脉灌注化疗
放射性粒子植入
静脉化疗
非小细胞肺癌
进展期
bronchial artery infusion chemotherapy
^(125)I radioactive seed
venous chemo-therapy
non-small cell lung cancer
progression stage
