^125I放射性粒子植入联合GP方案治疗老年非小细胞肺癌疗效观察

目的评价^125I放射性粒子植入联合GP方案治疗老年非小细胞肺癌（NSCLC）的可行性、安全性及其疗效。方法40例NSCLC中，初治24例，复治16例。男32例，女8例。年龄60～75岁。均行CT引导下瘤体内^125I粒子植入后3～5天，予GP方案：GEM1000mg／m^2，静滴30min，第1、8、15天；DDP30mg／m^2，静滴，第1～3天，28d为一周期，化疗2～4个周期。粒子植入后2个月（即化疗2周期后）进行近期疗效及毒副反应评价。结果^125I放射性粒子植入2个月后，40例患者全部可评价疗效。全组CR9例，PR23例，SD5例，PD3例，总有效率80．0％。初治组24例中，CR6例，PR14例，SD3例，PD1例，有效率83．3％；复治组16例中，CR3例，PR9例，SD2例，PD2例，有效率75．0％，两组差异无显著性（P〉0．05）。结论^125I放射性粒子植入联合GP方案化疗对不能手术的老年NSCLC患者是一种安全、可行、有效的治疗方法。

Observation of efficacy of implantation of radioactive ^125I particles combined with CP regimen in treatment of elderly patients with non-small cell lung carcinoma

Objective To evaluate the feasibility, safety and efficacy of implantation of radioactive ^125I partiele combined with GP Rx in treatment of NSCLC. Methods Of 40 NSCLC eases, 24 received primary treatment,and 16 returned treatment; 32 were males and 8 were females, and the average age was 60. 9 （from 60 to 75） years. During treatment, all patients received implantation of ^125I particles into tumors under the guidance of CT, then treated with GP Rx 3-5 days later（GP Rx： GEM 1000 mg/m^2, iv gtt for 30minutes, on the 1st, 8^th and 15^th days; DDP 30 mg/m^2, iv gtt, on the 1^st ,2^nd and 3^rd days; and 28 days composed one cycle, 2-4 cycles were given）. Two months after implantation of the ^125I particles （ehemotherapy for 2 cycles）, short-term curative effect and the toxic side-effect were evaluated. Results Two months after implantation of the ^125I particles, all the 40 cases could be evaluated for curative effect. In the whole group, there were CR 9 cases, PR 23 eases, SD 5 cases and PD 3 eases, the total effective rate was 80. 0%. In the primary treatment group, there were CR 6 eases, PR 14 eases, SD 3 cases and PD 1 ease, the effective rate was 83. 3%. In the returned treatment group, there were CR 3 eases, PR 9 eases, SD 2 cases and PD 2 cases, the effective rate was 75.0%. There was no remarkable difference between the two groups（ P 〉 0. 05 ）. Conclusion Implantation of radioactive ^125I particles combined with GP Rx is a safe, feasible and effective Rx for inoperable NSCLC in the elderly.