125I粒子植入联合化疗对小细胞肺癌生存期的影响

【目的】探讨125I粒子联合化疗治疗小细胞肺癌(small cell lung cancer,SCLC)的临床效果。【方法】治疗组(36例)采用CT引导下、PD(处方剂量)=8～10 Gy/h植入125I粒子,2 d后DDP+依托泊苷(vp-16)联合化疗方案。对照组(32例)单纯DDP+依托泊苷(vp-16)静脉化疗,药物剂量与治疗组参考标准相同。2个月后观察治疗效果(CR、PR、SD、PD)。根据采用癌症治疗功能评估评价生存质量,对生存率进行对比。【结果】技术成功率100%,术后随访率100%。治疗组CR 4例(11.1%),PR 14例(38.8%),SD 20例(55.5%),PD 8例(5.5%),CR+PR为49.9%;对照组:CR 1例(3.1%),PR 8例(25.0%),SD 14例(43.7%),PD9例(31.2%),CR+PR为28.1%,治疗组总有效率明显高于对照组(P<0.05)。治疗后1年生存率治疗组为61.71%,对照组为38.09%,2年生存率治疗组为32.25%,对照组为20.00%,治疗组明显优于对照组(P<0.05)。【结论】对于小细胞肺癌,125I粒子联合化疗具有优势互补作用,有利于短期内降低肿瘤负荷,提高近期疗效,并有效提高生存率。

Effect of 125I Seeds Implantation combined with EP on survival of SCLC patients

Objective]To explore the clinical value of radioactive partical ^125I seeds combined with EP in treating small cell lung cancer （SCLC）. Methods] A prospective cohort study of 68 patients, including experimental group（36 cases） who were undergone percutaneous CT guided intratumoral implantation. Treatment plan system （TPS） was used to design the distribution and number of ^125I seed according to PD=8 - 10 GY/h, EP chemical plan for 2 cycles, 2 days after operation. Control group（32 cases） was only given 2 EP chemotherapeutic cycles. CR, PR, SD and PD were evaluated after 2 EP chemotherapeutic cycles. Results ] Follow up was given for 2 months after operation, in experimental group the total effective rate was much higher than control group. The CR was 4（11.1%）, PR was 14（38.8%）, SD was 20（55.5%）, PD was 8（5.5%）, and CR＋PR was 49.9% in experimental group. The CR was 1 （3.1%）, PR was 8 （25.0%）, SD was 14（43.7%）, PD was 9（31.2%） and CR＋PR was 28.1% in the control group. The overall survival rates were 61.71% at 1 year and 32.25% at 2 years in experimental group, It was significantly statistic difference with control group. Conclusion ] Radioactive partieal ^125I seeds combined with EP make the two methods complement each other in treating SCLC. It can reduce tumor burden in the short term, improve therapeutic efficacy and highly improve the survival rate of SCLC patients.