放射性125I粒子联合化疗治疗晚期非小细胞肺癌的临床研究

目的探讨CT引导下125I粒子植入联合吉西他滨、顺铂（GP方案）化疗治疗晚期非小细胞肺癌的临床价值。方法 26例非小细胞肺癌患者（Ⅲa～Ⅳ期）,均先行吉西他滨联合顺铂静脉化疗2～3个周期,再行125I放射性粒子植入术,术前采用TPS治疗计划系统算出术中所需125I粒子数量、粒子分布情况、进针方向。在螺旋CT导向下将125I放射性粒子植入肿瘤实质内及肿瘤边缘。结果 26例患者中,完全缓解（CR）21例,部分缓解（PR）4例,稳定（NC）1例,进展（PD）0例。中位生存期14月,1年生存率76.92%。所有患者未出现放射损伤症状,未发现粒子迁移,有化疗不良反应（Ⅰ～Ⅳ度急性骨髓抑制,Ⅰ～Ⅲ度恶心呕吐,少量脱发）。结论放射性125I粒子植入联合联合化疗治疗非小细胞肺癌是安全有效的,具有一定临床应用价值。

Clinical Value of CT-guided Radioactive Seeds 125I Implantation Combined With GP Regimen Chemotherapy in the Treatment of Advanced Non-small Cell Lung Cancer

Objective To evaluate clinical effi cacy of CT-guided radioactive seeds 125I implantation combined with GP regimen（gemcitabine plus cisplatinum） chemotherapy in the treatment of advanced non-small cell lung cancer（NSCLC） . Methods Twenty-six patients with NSCLC（Ⅲa ～Ⅳstage） received venous GP regimen chemotherapy for two three periods at fi rst. CT-guided radioactive seeds 125I implantation was accepted and verifi ed according to treatment planning system（TPS） . Results Among 26 patients,CR was 21,PR was 8,NC was 1,PD was 0. Median survival time was 14 months and one year survival rate achieved 73.08%. All patients without symptoms that radiation injury,seeds migration,chemotherapy adverse reaction（Ⅰ～Ⅳacute myelosuppression,Ⅰ～Ⅲgastrointestinal reaction,mild trichomadesis） . Conclusions CT-guided radioactive seeds 125I implantation combined with GP regimen chemotherapy in the treatment of advanced non-small cell lung cancer is safe and effective,proves a certain clinical application value.