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目的探讨术中组织间植入125I放射性粒子治疗Ⅲb期非小细胞肺癌的疗效和可行性。方法对32例Ⅲb期肺癌患者行根治手术+术中植入125I及术后化疗。术中在瘤床及淋巴引流区,每隔1 cm植入125I 1粒,术后行TP方案化疗;设同期对照30例根治性手术+术后外照射放疗及化疗,比较两组的1、3年生存率和局控率,统计采用χ2检验。结果照射组及对照组随访超过36个月。125I组1、3年生存率分别为:63.8%,31.9%,对照组1、3年生存率分别为:50.6%,26.9%,两组生存率比较差异无显著性意义(P>0.05)。两组局控率比较,125I组高于对照组(P<0.05)。结论术中植入125可减少局部复发,对总的生存改善不明显,对Ⅲb期患者有望获得治疗益处。肺癌术中植入125I可作为综合治疗方法之一,以提高疗效。
Objective To investigate the efficacy and feasibility of intraoperative interstitial 125I radioactive particles in the treatment of stage Ⅲb non-small cell lung cancer. Methods Thirty-two patients with stage Ⅲb lung cancer underwent radical surgery plus 125I and postoperative chemotherapy. Intraoperative tumor bed and lymphatic drainage area, every 1 cm implanted 125I 1, TP regimen postoperative chemotherapy; set the same period 30 cases of radical surgery + postoperative external beam radiotherapy and chemotherapy, compared two groups of 1, 3-year survival rate and control rate, statistics using χ2 test. Results The irradiation group and the control group were followed up for more than 36 months. The 1-year and 3-year survival rates of 125I patients were 63.8% and 31.9% respectively. The 1-year and 3-year survival rates of the control group were 50.6% and 26.9%, respectively. There was no significant difference in survival between the two groups (P> 0.05). The two groups of control rate, 125I group was higher than the control group (P <0.05). Conclusion Intraoperative implantation of 125 can reduce the local recurrence, the overall survival and improvement is not obvious, for Ⅲ b patients is expected to receive treatment benefits. Intraoperative implantation of 125I lung cancer can be used as one of the comprehensive treatment to improve the efficacy.