TitleCT引导下125I放射性粒子植入治疗Ⅲ期非小细胞肺癌疗效分析
Other TitlesClinical efficacy of CT-guided 125 I radioactive seeds implantation for stage Ⅲ of non-small call lung cancer
Authors霍小东
郑广钧
柴树德
杨景魁
闫卫亮
冯震
孟娜
杨瑞杰
王俊杰
Affiliation300211,天津医科大学第二医院胸外科
北京大学第三医院肿瘤治疗中心放疗科
Keywords125I
非小细胞肺癌
疗效分析
125I
Non-small cell lung cancer(NSCLC)
Curative effect analysis
Issue Date2012
Publisher中华放射医学与防护杂志
Citation中华放射医学与防护杂志.2012,32,(2),199-203.
Abstract目的 探讨CT引导下125I放射性粒子植入治疗Ⅲ期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效及影响预后因素.方法 回顾性分析247例2002年6月至2009年6月,在天津医科大学第二医院接受125I放射性粒子植入治疗的Ⅲa/Ⅲb期NSCLC患者的临床疗效.对相关临床指标进行单因素、多因素预后分析.结果 患者治疗后,1、3、5年生存率分别为82.8%、23.8%和11.5%;中位生存时间为24.8个月.其中,Ⅲa期5年生存率为14.7%,中位生存时间为29.7个月;Ⅲb期5年生存率为11.2%,中位生存时间为24.0个月.1、3、5年局部控制率分别为92.2%、63.8%和25.7%.单因素分析结果显示,年龄、病程、治疗前血红蛋白值(≥120 g/L)、临床分期、瘤体最大直径、处方剂量、手术后平均剂量、手术后D100及治疗模式为患者预后影响因素;多因素分析结果显示,治疗前血红蛋白值(≥120 g/L)、手术后D100及瘤体最大直径为预后独立影响因素.结论 125I放射性粒子植入治疗Ⅲ期非小细胞肺癌显示了较好的疗效.治疗前血红蛋白值、手术后D100及瘤体最大直径为NSCLC患者预后的主要影响因素.
Objective To evaluate the clinical effects of CT-guided 125I radioactive seed implantation in treatment of stage Ⅲ non-small cell lung cancer ( NSCLC ) and the influential factors of prognosis.Methods 247 patients of stage Ⅲa/Ⅲb NSCLC underwent CT-guided 125I radioactive seed implantation.The clinical effects and the factors affecting prognosis were analyzed by univariate and multivariate analyses.Results The 1-,3-,and 5- year overall survival rates were 82.8%,23.8%,and 11.5 %,respectively.The median survival time was 24.8 months,and the local control rate was 92.2 %,63.8%,and 25.7%,respectively.The 5- year overall survival rate was 14.7%,and the median survival time was 29.7 months of the stage Ⅲ,patients.And the 5- year overall survival rate was 11.2%,and the median survival time was 24.0 months at the stage Ⅲb.Univariate analysis showed that age,course of disease,hemoglobin before treatment,clinical stage,maximum diameter of tumor,prescribed dose (PD),post-operational mean dose,post-operational dose covering 100% volume (D100),remedial model were the main prognostic factors; however,multivariate analysis revealed that hemoglobin ≥ 120 g/L before treatment,post-operational dose covering 100% volume (D100) and maximum diameter of tumor were the independent risk factors for predicting the survival.Aerothorax was observed in 37 patients with an incidence rate of 14.9%,and hemothorax was observed in 22 patients with an incidence rate of 9%.Conclusions 125I radioactive seed implantation therapy is effective in the treatment of stage Ⅲ NSCLC.Hemoglobin level before treatment,post-operational dose covering 100% volume (D100 ),and maximum diameter of tumor are the main prognostic factors for the NSCLC patients treated with radiotherapy for NSCLC.
URIhttp://hdl.handle.net/20.500.11897/285777
ISSN0254-5098
DOI10.3760/cma.j.issn.0254-5098.2012.02.023
Indexed中文核心期刊要目总览(PKU)
中国科技核心期刊(ISTIC)
中国科学引文数据库(CSCD)
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