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目的:研究32P-磷酸铬(32P胶体)在肺癌手术中组织间照射对淋巴道隐匿性转移灶的治疗作用。方法:通过对73例肺癌患者采用手术切除肿瘤并配合32P胶体间质注射,并以同期同病种单纯手术治疗58例为对照,观察术后32P胶体在体表动态分布情况、并发症发生率、不同病理类型各组术后锁骨上淋巴结(SCL)转移率及1、3和5年生存率。结果:手术+32P胶体组及对照组均无手术死亡。两组淋巴结阳性率及术后主要并发症发生率均无显著性差异(χ2=0.003~1.696,P>0.05)。手术+32P胶体组术后锁骨上淋巴结转移发生率明显低于单纯手术组(χ2=4.507~5.348,P<0.05,P<0.01)。手术+32P胶体组和单纯手术组1、3和5年生存率分别为82.2%、56.2%和38.7%;77.6%、41.7%和25.5%。其中1年的生存率组间比较无显著性差异(χ2=0.659,P>0.05);3和5年组间生存率比较均有显著性差异(χ2=4.207、3.997,P<0.05)。结论:32P胶体在肺癌切除术中间质注射是一种安全、有效杀灭隐匿性转移灶以控制术后肿瘤局部复发和远处转移,并可以延长病患生存期的治疗方法。
Objective: To investigate the therapeutic effect of 32P-chromic phosphate (32P colloids) on the occult metastasis of lymph nodes in interstitial irradiation of lung cancer. Methods: Totally 73 patients with lung cancer were treated with surgical resection of the tumor and 32P colloid interstitial injection. In the same period, 58 cases of the same disease were treated by surgery. The dynamic distribution of 32P colloid in the body surface and the incidence of complications were observed. The postoperative SCL metastasis rate, 1,3 and 5 year survival rate of each pathology group were compared. Results: There was no operative death in the operation + 32P colloid group and the control group. There was no significant difference in the positive rate of lymph nodes and the incidence of postoperative major complication (χ2 = 0.003-1.696, P> 0.05). The incidence of supraclavicular lymph node metastasis after surgery + 32P colloid group was significantly lower than that of surgery alone group (χ2 = 4.507-5.348, P <0.05, P <0.01). The 1, 3 and 5-year survival rates were 82.2%, 56.2% and 38.7%, 77.6%, 41.7% and 25.5% respectively in the operation + 32P colloid group and the simple operation group. There was no significant difference in one-year survival rate between two groups (χ2 = 0.659, P> 0.05). There was significant difference in survival between 3 and 5 years (χ2 = 4.207, 3.997, P <0.05). Conclusion: Intraperitoneal injection of 32P colloid in lung cancer resection is a safe and effective method to kill occult metastases and control the local recurrence and distant metastasis of tumor after operation, and can prolong the survival of patients.