| Objective: A retrospective analysis was made on the efficacy and adverse reactions of radioactive iodine 125 particles implantation and external radiotherapy in the treatment of lung cancer;The variation of radiation dose effect of iodine 125 particles to the surrounding environment with time,distance,number of particles and its safety;The degree of patients knowledge about radiation protection of iodine 125 particles and the necessity of safety knowledge education.Methods: From October 2017 to October 2018,40 patients with lung cancer were admitted to the Department of Respiratory Medicine,Yueyang People’s Hospital of South China University.All patients were diagnosed by CT-guided percutaneous puncture of bronchoscopic biopsy.The patients were random divided into study group and control group with 20 cases.The study group was treated with iodine 125 seed stereo implantation,while the control group was treated with external radiotherapy.The maximum diameter of thoracic CT was measured within 1 week before operation,2 months,4 months and 6months after operation.Serum carcinoembryonic antigen(CEA),cytokeratin fragment(CYRA21-1),neurospecific enolase(NSE)levels and adverse reactions were measured by venous blood sampling;The day,January,March,April,May,and June after particle insertion without any protection or lead-coat protection in radiation dose of 0 cm,10 cm,20 cm,30 cm,40 cm,50 cm,60 cm,70 cm,80 cm,90 cm,100 cm were measured;Before and after the safety education,the questionnaire of iodine 125 particle radiation knowledge was collected from family members,and the knowledge level of the two questionnaires was rated as four different grades(poor,general,good and excellent).Results: 1.Chest CT was followed up 2,4 and 6 months after treatment in iodine 125 particle group and external radiotherapy group.After 2 months of follow-up in iodine,there were 1 cases of complete remission,11 cases of partial remission,8 cases of stable disease and 0 cases of progressive disease in the study group.The local control rate was 100%.After 2 months of follow-up in external radiotherapy,there were 1 case of complete remission,9 cases of partial remission,8 cases of stable disease and 2 case of progressive disease.The local control rate was 90%.The study group was followed up for 4months after treatment,with complete remission in 2 case,partial remission in 11 cases,disease stabilization in 5 cases,disease progression in 2 cases.The local control rate was 90%.The control group was followed up for 4 months after treatment,with total remission in 1 case,partial remission in 7 cases,disease stabilization in 7 cases and disease progression in 5 cases.The local control rate was 75%.Six months follow-up showed 3 complete remission,11 partial remission,3 stable disease and 3 progressive disease in the study group.The local control rate was 85%.The control group were followed up for 6 months after treatment,with 1 case of complete remission,6 cases of partial remission,4 cases of stable disease and 9 cases of progressive disease.The local control rate was 55%.The local control rate of iodine 125 particle treatment group was significantly better than that of external radiation treatment group.There was no significant difference in The local controlrate between February and April(p > 0.05),and there was significant difference in June(p<0.05).2.In the study group,CEA,NSE and CYFRA21-1 decreased in 2months after implantation of radioactive iodine 125 seeds,with statistical significance(p<0.05).CEA,NSE and CYFRA21-1 levels were lower in2,4 and 6 months after treatment,but there were no significant difference between the two groups(p>0.05).Comparisons of different therapeutic effects showed that CEA,NSE and CYFRA21-1 in effective group were significantly lower than those before treatment(p<0.05).CEA,NSE and CYFRA21-1 in invalid group were significantly higher than those before treatment,and the difference was statistically significant(p<0.05).3.In this study,there were 4 cases of pneumothorax in iodine 125 seed group,of which 3 cases were small pneumothorax <20%,1 case was about 30%.There were 3 cases of hemoptysis,2 cases of chest pain,1 case was severe leukopenia.There were no radiation pneumonia skin injury,radiation esophagitis,particle migration and acute serious adverse reactions during the observation.Four cases in external radiation therapy group were reported,Leukocyte count was reduced in 1 case,mild thrombocytopenia in 2 cases and mild radiation pneumonia in 4 cases.No complications such as radiation fistula,esophagitis after treatment.There was significant difference in toxicity between in the two groups(p<0.05).4.The radiation rate of iodine 125 particles decreases rapidly with time and distance.The radiation dose around iodine 125 particles is positively and strongly correlated with the number of particles.It is safe under the protection of lead clothing,and the difference was statistically significant(p<0.05).5.It is necessary to educate and educate patients about the safety of iodine 125 seeds implantation.It can increase the knowledge andcompliance of patients about radiation protection,so as to avoid the risk of radiation damage to their relatives.Conclusion:1.Compared with external radioactivity,iodine 125 seed implantation has better therapeutic effect and fewer complications,and can reduce the levels of CEA,NSE and CYFRA21-1 tumor markers.However,the level of tumor markers varies with different therapeutic effects.2.The radiation rate of iodine 125 particles decreases rapidly with time and distance.The radiation dose around iodine 125 particles is positively and strongly correlated with the number of particles.3.The radiation effects on the surrounding environment are safe and controllable after lead shielding and safety education for iodine 125 seeds patients during and after operation. |
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