^125I粒子与放疗分别联合化疗治疗Ⅲb期NSCLC的比较

目的比较^125I粒子组织间植入和外放疗分别联合化疗治疗局部晚期非小胞肺癌（non-small cell lung cancer，NSCLC）的疗效与安全性。方法76例Ⅲb期NSCLC患者，观察组37例接受^125I放射性粒子植入后联合同步NP方案化疗，对照组39例接受外放疗同步NP方案化疗。结果观察组和对照组总有效率、局部控制率分别为78．4％和56．4％、91．9％和74．4％，均有显著性差异（P〈0．05）；两组1年生存率分别为67．6％和66．7％，无显著性差异（P〉0．05）；两组治疗相关死亡率分别为0％和10．3％，有显著性差异（P〈0．05）。对照组发生Ⅲ、Ⅳ度放射性食管炎、Ⅲ、Ⅳ度放射性肺炎和Ⅲ、Ⅳ度白细胞减少分别为15．4％、10．3％和41．0％，观察组所有病例未出现Ⅲ-Ⅳ放射性肺炎及食管炎，Ⅲ-Ⅳ度白细胞发生率为18．9％，差异均有统计学意义（P〈0．05）。结论放射线^125I粒子组织间植入联合同步化疗治疗局部晚期NSCLC具有较好的疗效和安全性。

Compare of chemotherapy respectively combining with implantation of125 radioactive seed by instersticial brachytherapy and external beam radiotherapy in staged Ⅲb non-small cell lung cancer

Objective To compare efficiency and toxicity of chemotherapy respectively combining with implantation of 125 radioactive seed by insterstieial braehytherapy and external beam radiotherapy in staged Ⅲ b non -- small cell lung cancer. Methods Seventy - six patients with staged Ⅲ b non - small cell lung cancer were selected, among of which 37 cases, the observed group was treated with NP scheme synchronization chemotherapy combining with implantation of 125 radioactive seed by insterstieial braehytherapy while others,the control group was given concurrent ehemoradiotherapy. Results The observed group and the control group respectively achieved total response rate of 78.4% and 56.4% （P 〈 0.05 ）, local control rate of 91.9% and 74.4% （P 〈 0.05 ）, treatment related death rate of 0% and 10.3% （P 〈 0.05 ） , 1 year survival rate of 67.6% and 66.7% （P 〉 0.05 ）. No one was seen acute radiation - pneumonia, acute radiation - esophagitis in the observed group. Acute radiation - pneumonia, acute radiation - esophagitis , respleukoeytopenia and thromboeytopenia were respectively 0% and 10.3% （ P 〈 0.05） ,0% and15.4%（P 〈 0.05）, 18.9% and41.0%（P 〈 0.05） ,0% and 2.5% （P 〉 0.05） in the aboved two groups. Conclusion The means of concurrent chemotherapy combining with implantation of ^125I radioactive seed by insterstieial braehytherapy in staged Ⅲb non - small cell lung cancer provides more satisfactory effectiveness and reliability.