摘要
目的评价姑息性手术125I粒子植入联合热疗及化疗综合治疗晚期肺癌的方法和疗效。方法28例肺癌中原发性非小细胞肺癌(NSCLC)15例(ⅢA期9例,ⅢB期6例),NSCLC手术后局部复发6例,转移性肺癌7例(其中结肠癌肺转移3例,乳癌肺转移4例)。采用开胸姑息切除+125I粒子植入+体外高频透热治疗(HFDT)+化疗17例,胸腔镜附加小切口行局部肿块(楔形)切除+125I粒子植入+HFDT+化疗6例,肿瘤内射频消融(RFA)+125I粒子植入+化疗5例。结果全组随访12～32个月(平均16.9个月)。CR21例,PR6例,NR1例。1年后局部复发4例,2例经再次植入125I又得到控制。5例患者死亡,1例因局部复发,4例因远处转移。所有患者植入125I粒子后无白细胞、血小板降低,无肝肾功能损害,均能较好耐受同时化疗。结论本治疗方法安全可行,有较高的肿瘤局部控制率,患者生活质量高,生存期延长。
Objective To evaluate the methods and efficacy of the combined therapy based on palliative resection,implantation of ()^(125)I seeds,thermotherapy,and chemotherapy for advanced lung cancer.Methods From November 2000 to July 2002,28 cases of lung cancer were treated,including 15 cases of primary non-small cell lung cancer (NSCLS)(9 cases in stage Ⅲ_A,6 cases in stage Ⅲ_B),6 cases of postoperative recurrent NSCLS,7 cases of metastatic lung cancer (3 cases from colon cancer,4 cases from breast cancer).The tumors in 17 cases were treated with the combined therapy based on palliative resection,implantation of ()^(125)I seeds,high-frequency diathermic therapy(HFDT)and chemotherapy.The tumors in 6 cases underwent local wedge resection with video-associated thoracoscope,implantation of ()^(125)I seeds,HFDT and chemotherapy.The tumors in 5 cases underwent radio frequency ablation (RFA),implantation of ()^(125)I seeds and chemotherapy.Results All the patients were followed-up for 12-32 months (average 16.9 months).The control rate of the tumors was 96%(the complete remission in 21 cases,the partial remission in 6 cases) and the non-remission was 1 case.One year later,4 cases had local recurrent cancer.Two of them received implantation of ()^(125)I seeds again and the tumors were controlled.Four of 5 dead cases died of distant metastases.All the patients with implanted ()^(125)I seeds had no decrease in white blood cells and platelets,no damage to hepatorenal function,and bore chemotherapy well.Conclusion This combined therapy is safe and practical and results in high local control rate of tumor,high life quality,and satisfactory survival time.
出处
《中国肿瘤临床与康复》
2005年第1期39-41,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
基金
上海科技发展基金资助(项目编号:004119045)
关键词
肺肿瘤
姑息手术
^125I粒子
热疗
Lung neoplasms
Palliative resection
Brachytherapy
()^(125)I seeds
thermotherapy
