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目的探讨放射性125I粒子组织间植入联合静脉化疗对Ⅲb期、Ⅳ期非小细胞肺癌(NSCLC)的疗效。方法Ⅲb期、Ⅳ期NSCLC患者按治疗方法不同分为2组。联合组(n=43)125I粒子植入3天后,联合TP(紫杉醇+顺铂)方案或GP(吉西他滨+顺铂)方案化疗;对照组(n=47)仅接受TP或GP方案化疗。比较2组治疗有效率、生存率和中位生存期。结果联合组和对照组Ⅲb期患者的近期局部总有效率分别为84.00%、48.28%,Ⅳ期患者有效率为72.22%、33.33%,组间差异均有统计学意义(P均<0.05)。联合组和对照组Ⅲb期患者1、2年生存率分别为67.80%、36.00%和37.90%、13.83%,差异有统计学意义(P<0.05),两组中位生存期分别为15.7个月、8.6个月;联合组和对照组Ⅵ期患者1、2年生存率分别44.44%、16.70%和22.22%、11.10%,差异无统计学意义(P>0.05),两组中位生存期分别为8.9个月、6.0个月。结论 125I粒子组织间植入联合静脉化疗对Ⅲb期、Ⅳ期NSCLC患者的近期疗效良好,对于Ⅲb期NSCLC患者,联合治疗方案可提高患者的生存率。
Objective To investigate the efficacy of radioactive 125I interstitial implantation combined with intravenous chemotherapy for stage Ⅲb and Ⅳ non-small cell lung cancer (NSCLC). Methods Ⅲ b, Ⅳ NSCLC patients according to different treatment methods are divided into two groups. In the combined group (n = 43) 125I particles were implanted three days later with either TP (paclitaxel + cisplatin) or GP (gemcitabine + cisplatin) regimen and control (n = 47) with TP or GP regimen alone. Compare the two groups of treatment efficiency, survival rate and median survival. Results The total effective rates of the patients in the combined group and the control group were 84.00% and 48.28% respectively in the stage Ⅲb patients. The effective rates in the stage Ⅳ patients were 72.22% and 33.33%, respectively. All the differences were statistically significant (all P <0.05). The 1-year and 2-year survival rates of Ⅲb patients in combined group and control group were 67.80%, 36.00% and 37.90%, 13.83% respectively, with significant difference (P <0.05). The median survival time was 15.7 months , 8.6 months respectively. The 1-year and 2-year survival rates of patients in group Ⅵ of the combined group and control group were 44.44%, 16.70% and 22.22%, 11.10% respectively, with no significant difference (P> 0.05). The median survival time 8.9 months, 6.0 months. Conclusion 125I seeds interstitial implantation with intravenous chemotherapy has a good short-term curative effect on patients with stage Ⅲb and Ⅳ NSCLC. The combination therapy can improve the survival rate of patients with stage Ⅲb NSCLC.