Observation On The Curative Effect Of Transdermal Implantation Of Radioactive 125Ⅰ Seeds In The Treatment Of Lung Cancer

Background At present,the incidence and mortality of lung cancer are increasing year by year.Lung cancer has developed into a major malignant tumor that threatens human life and health and affects the quality of life.Objective The clinical efficacy and safety of radioactive seeds ¹²⁵I in the treatment of lung cancer were retrospectively analyzed.Methods（1）Patients with lung cancer who were admitted to Yichang Central People’s Hospital from January 2015 to January 2018 and met specific inclusion criteria were selected as the study subjects.（2）Relevant clinical information of lung cancer patients was reviewed and recorded in detail,including gender,age,smoking history,pathological classification,tumor diameter,basic medical history,related complications,treatment methods and pre-treated hemoglobin,etc.KPS score,pain score and TNM stage were evaluated.（3）Included in the study according to the different methods of treatment of lung cancer patients are divided into three groups A,B,C,including particle treatment group（group A）,radiotherapy group（group B）,and not particle radiation therapy group（group C）,all included in the study of lung cancer patients receiving long-term follow-up,then every 3 months up to46 months follow-up,the median for 20 months.Routine laboratory tests and imaging tests were performed to determine possible complications.The relevant auxiliary examination results,pain score,radiation pneumonia status,recurrence time and time of death were recorded in detail.The differences of short-term efficacy,remission rate of clinical symptoms,long-term survival rate and related complications among the three groups were compared.（4）Log-rank test was used to compare the differences in survival time between each single grouping variable in lung cancer patients receiving radioactive ¹²⁵I seed implantation,and multivariate analysis was conducted for univariate factors with statistical significance.Results（1）Now screening during January 2015 to January 2018,in the center of the yichang people’s hospital meet specific inclusion criteria of 384 cases of patients with lung cancer,with 127 cases patients of group A and group B patients 125 cases,132 cases of patients with group C,three groups of patients age,sex,tumor diameter,hemoglobin index before treatment,smoking history and other related clinical information there was no significant difference.（2）In terms of short-term efficacy,tumor response of lung cancer patients in group A,B and C was significantly different.The local tumor control rates of group A at 3 and 6 months after treatment were 68.5%and 66.1%,respectively,and the total effective rates were 89.9%and 87.4%,respectively,which were significantly higher than those of group B and group C.In terms of clinical symptom remission rate,A,B,C three groups have significant difference between different treatments,prompt difference between specific groups A,B two groups clinical symptom remission rate,and A and C two groups clinical symptom remission rate have significant difference,show that particle treatment group can significantly improve the clinical symptoms in patients with lung cancer,improve patient quality of life.（3）As for post-treatment related complications,all patients in the three groups had a certain degree of leukopenia,and the incidence of leukopenia was not significantly different.The incidence of radiation pneumonia and radiation esophagitis in the particle treatment group was significantly lower than that in the conventional radiotherapy group.Complications after further analysis of radioactive particles implantation,patients in group A received¹²⁵I radioactive particles implantation after CT examination found that have occurred in 16 patients with pneumothorax,rate of 12.6%,occurred in seven of the 16patients of pneumothorax patients with thoracic cavity closed drainage treatment,the rest of the 9 cases of mild pneumothorax patients received conservative treatment,only the final pneumothorax patients were fully recovered,six patients have A mild hemoptysis,its incidence of haemoptysis is 4.7%,but after hemostatic drug treatment 3 days after symptoms disappear.Mild particle displacement occurred in 6 patients（4.7%）,and 49 patients underwent radioactive particle reimplantation.（4）Univariate analysis showed that pretreated hemoglobin,cutoff point of 120g/L,smoking history,tumor diameter（cm）,clinical stage and other factors were related to survival of patients with radioactive ¹²⁵I seed implantation,while age and gender had no significant effect on survival.Multiple regression analysis showed that the main factors affecting the prognosis of lung cancer patients were tumor stage,tumor diameter,and pathological type,among which tumor stage and pathological type were significant predictors of OS.Conclusion Radioactive ¹²⁵Ⅰ particle percutaneous implantation is a safe and effective for the treatment of lung cancer treatment,the short-term curative effect is good,can obviously alleviate the clinical symptoms of patients with lung cancer,and no serious postoperative complications,more important is to be able to prolong survival in patients with stage,including pretreatment of hemoglobin,smoking history,tumor size,clinical stage survival factors associated with radioactive ¹²⁵I particle implant survival.