Comprison Of ¹²⁵? Particle Implantation Treatment For Different Pathological Types Of Pulmonary Cancer In The Short-term

Objective:The purpose of this study was to investigate the clinical parameters changes of¹²⁵? radioactive particle implantation in treating different types of lung cancer including tumor size,plasma marker value,improvement in quality of life and related side effects.Methods:Retrospective analysis was used for this research.A total of 65 cases of 51 male patients and 14 female patients were included.All patients were clearly diagnosed as malignant lung tumors by pathological biopsy,with an average age of 65.26±8.826 years.Nine of these patients were small cell lung cancer.There were 36 patients with squamous cell carcinoma,15 with adenocarcinoma,and 5 with other non-small cell lung cancer.General information was collected such as current medical history,past history,personal history,family history,and KPS scores of these patients.All patients underwent chest plain scan+enhanced CT examination before operation,and then input the obtained CT image into the TPS treatment planning system to determine the total number of particles expected to be implanted by the patient and design the optimal implantation path in advance.All patients were followed up for at least 6 months at regular intervals.The tumor size,serum tumor marker levels,changes in KPS scores and the incidence of adverse reactions were compared between the preoperative and postoperative 2nd,4th,and 6th month.Results:1.The short-term effect according to the latest RECIST 1.1solid tumor evaluation criteria show that 11 patients were completeresponse?CR?,28patientswerepartial response?PR?,16 patients were stable disease?SD?,10 patients were progressive disease?PD?.The overall response rate?CR+PR?was 60.0%,the disease control rate?CR+PR+SD?was84.6%.Statistical analysis both overall response rate and disease control rate administrated that there was no statistically significant between SCLC group with NSCLC?P>0.05?.In addition,comparing the disease control rate with effective rate of NSCLC for the different pathological types after treatment for the 2nd,4th,and 6th month,the result of which was no significant difference in the efficacy of different pathological types of non-small cell lung cancer.2.The result displayed the tumor markers re-examined after¹²⁵? seed implantation treatment had a downward trend overall.The CEA,NSE,and CYFRA21-1 levels re-examined at the 2nd month after surgery were statistically significant comparing to before surgery.The levels of CEA and NSE re-examined at the 4th month after operation were different from those before operation,and the CEA re-examination at the 6th month after operation was statistically significant?P<0.05?.Compared the preoperative with postoperative levels of CEA,NSE,and CYFRA21-1 in different pathological types:the serum CEA levels of patients in the adenocarcinoma group were significantly lower than that before surgery?P<0.05?;the serum NSE levels of patients in the small cell lung cancer group were lower than those before the operation at the 2nd,4th,and 6th month,and the decrease was significant at the 2nd and 4th month after the operation?P<0.05?.The levels of CYFRA21-1 in patients with squamous cell carcinoma at the 2nd,4th and 6th month after operation and at the 4th and 6th month after adenocarcinoma group were statistically lower than those before operation.3.In this study,65 patients underwent KPS evaluation before and the 6th month after¹²⁵? radioactive particle implantation.Statistical analysis showed that the KPS score at the 6th month after surgery was significantly higher than that before surgery?z=-2.873,P=0.004<0.05?.4.The results of the non-conditional Logistic model show whether the combination of chemotherapy is a factor that affects the curative effect.that is,the postoperative curative effect is more significant in patients with chemotherapy?P=0.038<0.05,b:-1.243,OR=0.289,95%CI:0.089-0.931?.5.No serious complications occurred in all patients.A total of 11 patients had complications:the incidence of pneumothorax was 13.8%,the incidence of subcutaneous gas was7.7%,the incidence of hemoptysis was 6.2%,and the incidence of chest pain was 3.1%,the incidence of pleural effusion was4.6%,and the incidence of radiation pneumonia and particle migration were 1.5%.All complications were gradually relieved after symptomatic supportive treatment.Conclusion:1.¹²⁵? radioactive particle implantation treatment of lung cancer short-term clinical effect is better,its complications are mild,which can effectively improve the quality of life of patients.There is no difference in the short-term efficacy between different pathological types of lung cancer.2.¹²⁵? radioactive particle implantation can reduce the levels of various tumor markers effectively in the short term.The levels of CEA,NSE and CYFRA21-1 decreased inconsistently before and after surgery for different types of lung cancer.3.Whether combined chemotherapy is a risk factor that affects the efficacy of¹²⁵? radioactive particle implantation treatment.The postoperative effect of patients with chemotherapy is more significant.