| Objective:Previous studies have shown CT guided iodine 125 seed implantation therapy is inoperable non-small cell lung cancer safe, feasible and effective way. In view of this present study was to compare CT guided 1251 seed implantation or IMRT for patients with stage IV squamous cell lung carcinoma of efficacy and safety.Methods:We collected 52 cases of palliative local treatment IV squamous cell lung carcinoma patients, the survival of patients are expected to more than three months, at least through the first-line platinum-based chemotherapy regimen after progression in patients with advanced squamous cell carcinoma of the lung, the lung lesions progress limitations based on the presence or vena cava, esophagus oppression, atelectasis clear indications of radiotherapy. According to the patient using iodine 125 seed implantation conformal or intensity modulated radiation therapy group,24 patients underwent CT-guided 1251 seed implantation radiotherapy and 28 patients received conformal IMRT. Comparison of two groups of patients after local control rate, time to progression, overall survival, acute and chronic adverse effects and quality of life.Results:Accepted iodine 125 seed implantation doses to patients with lesions of 100-140Gy, four weeks after the evaluation of 18 cases achieved partial remission and 5 patients achieved stable,1 cases of disease progression. Remission rate was 75.0%. Three months after the evaluation of 19 cases achieved complete remission or partial remission, stable 3 cases,2 cases of disease progression, remission rate was 79.1%. The median time to progression was 5.0 ± 0.8 months. Conformal intensity modulated radiation therapy doses lesion patients 56～ 60Gy,14 cases evaluating partial remission,12 cases evaluated stable,2 cases of disease progression. Remission rate was 50.0%(p<0.05). Three months later with the 12 patients achieved complete remission or partial remission and 13 patients achieved stable,3 cases of disease progression, remission rate was 42.9%. The median time to progression was 4.7± 0.6 (p> 0.05). Accepts seed implantation occurred during the two cases and one case of pneumo-thorax hemoptysis, nine cases of mild radiation pneumonitis and no radiation-related bronchi-tis, coughing up blood and deadly esophageal fistula. Receiving IMRT in patients with radiat-ion pneumonitis occurred in 16 cases and radioactive lesions occurred in 5, no concurent radiation esophagitis. Quality of life, from QLQ-C30 scale found iodine 125 seed implanta-tion group has more significant advantages in terms of the overall state and emotional function, and in January, in dyspnea, cough and hemoptysis less after March, statistically different sets of data. Other aspects of quality of life, iodine 125 seed implantation group no symptoms worse than IMRT group.Conclusions:1.1251 seed implantation contrast IMRT treatment shows better PFS and OS, with a statistically significant result, display 1251 seed implantation in patients with advanced squamous cell carcinoma of the lung have better clinical efficacy and clinical application, but need to expand the sample size to be confirmed.2. Iodine 125 radioactive seed implantation group appear less pneumonia and skin lesions compared with IMRT group, but need to be confirmed by a larger sample size.3.Compared with the IMRT group, iodine 125 seed implantation can significantly improve the quality of life of patients. |
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