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目的探讨动脉灌注化疗联合~(125)I粒子植入治疗非小细胞肺癌(NSCLC)的临床疗效与安全性。方法纳入2012年2月至2013年6月我科收治的无法手术切除的NSCLC患者34例,其中18例患者单纯接受了~(125)I粒子植入治疗,16例给予联合动脉灌注化疗。对所有患者进行随访,在~(125)I粒子植入术后2个月复查胸部CT,按实体瘤疗效评价标准评价治疗效果并进行生存分析。结果患者手术成功率为100%,未出现严重并发症。2个月后复查结果显示:单纯粒子植入组有效率为72.2%,联合动脉灌注化疗组有效率为87.5%,两组治疗的有效率差异无统计学意义(χ2=1.122,P>0.05),中位生存时间分别是361 d和470 d,两组差异有统计学意义(χ2=2.985,P<0.05),1年生存率分别为43.5%和83.5%,两组差异有统计学意义(χ2=4.101,P<0.05)。结论动脉灌注化疗联合~(125)I粒子植入治疗不可切除的NSCLC安全可靠、疗效肯定,能延长患者生存期。
Objective To investigate the clinical efficacy and safety of intra-arterial chemotherapy combined with 125 I seed implantation in the treatment of non-small cell lung cancer (NSCLC). Methods Thirty-four patients with unresectable NSCLC who were admitted to our department from February 2012 to June 2013 were enrolled. Among them, 18 patients received 125I I seed implantation alone and 16 patients received combined arterial infusion chemotherapy. All the patients were followed up. The chest CT was reviewed two months after the 125 I seed implantation. The therapeutic effect was evaluated and the survival analysis was performed according to the evaluation criteria of solid tumor efficacy. Results The success rate of patients was 100%, no serious complications. Two months later, the results showed that the effective rate was 72.2% in the simple particle implantation group and 87.5% in the combined arterial infusion chemotherapy group, with no significant difference in the effective rates between the two groups (χ2 = 1.122, P> 0.05) , The median survival time was 361 d and 470 d respectively, with significant difference between the two groups (χ2 = 2.985, P <0.05). The 1-year survival rates were 43.5% and 83.5% respectively, with significant difference between the two groups χ2 = 4.101, P <0.05). Conclusion Intra-arterial chemotherapy combined with ~ (125) I seed implantation in the treatment of unresectable NSCLC is safe, reliable and effective, which can prolong the survival of patients.