| Objective To evaluate the efficacy of systemic chemotherapy combined with125Ⅰ seed implantation in the treatment of advanced non-small cell lung cancer（NSCLC）.Methods the data of 85 patients with advanced NSCLC in our hospital from January2010 to January 2015 were analyzed retrospectively.All patients in the present study were not eligible for or refused surgical or targeted medication because of tumor staging,physical or economic conditions.All the patients were diagnosed as NSCLC by pathologic examinations.There were no statistically significant differences of baseline characteristics between the two groups before operation,as such,they were comparable.According to different treatment methods,all patients were divided into the control group,which was treated with systemic chemotherapy alone in 43 patients,and observation group,which was treated with systemic chemotherapy combined with 125Ⅰ particle implantation treatment in 42 patients.In the observation group,the 125Ⅰ particles were implanted after systemic chemotherapy（4 courses）,and the 125Ⅰ particles were implanted under CT guidance according to the treatment plan system（TPS）,and the dose was verified after operation.The patients were followed up regularly,and the serum tumor markers and blood routine results were recorded.The difference of serum tumor markers and the existence of bone marrow suppression were observed.The quality of life of patients by evaluating the Karnofsky score,3 months after operation through the review,enhanced CT or MRI image,to observe the changes of tumor volume of lesions,radioactive particle location,spatial arrangement,tumor enhancement;survival rate between the two groups were compared.Results The successful rate of the first implantation of target iodine particles in the observation group was 97.6%（41/42）,and the average target dose for the target area was（210240）Gy.Only 1 patient（V90 < 90%）accept a particle after replant.The local squamous cell carcinoma of the total effective rate in the observation group after 3months was 64.70%（11/17）,adenocarcinoma of the local total effective rate was 76%（19/25）,total local efficiency（CR+PR）was 71.42%（30/42）;the local squamous cell carcinoma of the total effective rate in the control group after 3 months of was 7/17（41.17%）,adenocarcinoma local cancer total effective rate was 10/26（38.46%）,the total local efficiency（CR+PR）was 39.53%（17/43）;the total efficiency of the observation group（CR+PR）after 3 months group was significantly better than that of control group（P < 0.05）,there was significant difference.A group of patients with 1,2year cumulative survival rate were 59.20%,28.60%;which in the control group were34.60%,14.00%,median survival time（14.7 months）were higher than that of the control group（7.6 months）,the difference was statistically significant（c2= 5.503.P =0.019）.The survival rate of patients in stageⅢb and IV were respectively analyzed.The median survival time was 15.9 months and the cumulative survival rates of 1 and 2years were 68% and 36% respectively.In the control group,the median survival time was 8.3 months,the cumulative survival rate of 1 and 2 years was 38.50% and 15.38%,and the survival rate of theⅢb in the observation group was significantly higher than that of the control group,the difference was statistically significant（c 2 =5.934,P=0.015）;the difference was statistically significant.The median survival time of IV patients in observation group was 8.6 months,1,2 year survival rates were 45.80% and17.60%,that of the control group was 6.3 months,1,2 year survival rates were 22.10%,11.80%,and survival of patients with stage IV was higher than that of the control group group,but 2 years survival rate difference was not statistically significant（c2 = 1.446,P= 0.229）.Postoperative CEA levels in two groups decreased,but 1 months after observation treatment group（10.11 + 0.71）g/L,decreased levels was lower than the control group after 1 months（12.11 + 0.72）g/L,there was a significant difference between the two groups（t=11.901,P=0.001）.There were no statistically significant differences in blood routine between preoperative and postoperative changes（P > 0.05）in the observation group.Meanwhile,there was no significant difference in blood routine between the two groups after 1-month（P > 0.05）.All patients had no serious complications such as pulmonary abscess,bleeding,pericardial tamponade,and needle channel metastasis.Conclusion Systemic chemotherapy combined with 125Ⅰ radioactive particle implantation is a safe and effective treatment strategy for advanced NSCLC. |
