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目的评价雷帕霉素联合碘-125(I125)治疗中晚期非小细胞肺癌(NSCLC)的临床疗效。方法 92例NSCLC患者随机分为对照组和试验组,每组46例,对照组按照粒子植入治疗计划系统(TPS)制定粒子治疗计划,在电子计算机断层扫描(CT)引导下将I125植入肿瘤内,处方剂量为90 Gy。试验组在此基础上加用雷帕霉素,每次2 mg,每天1次,3周为1个疗程,治疗4个疗程。治疗结束后4周进行CT扫描,参照实体瘤疗效评价标准(RECIST)进行疗效评价;观察并记录患者治疗后的卡式体能状态评分(KPS)、体重指数(BMI)和疾病进展时间(TTP);记录2组的生存期和不良反应。结果试验组客观缓解率(43.48%)显著高于对照组(30.43%,P<0.05);2组患者治疗后KPS、BMI和TTP较治疗前升高(P<0.01,P<0.05,P<0.01),试验组治疗后上述指标显著高于对照组(P<0.05,P<0.01,P<0.05);试验组中位生存时间为17.03个月,1年生存率为74.52%,显著高于对照组的13.16个月和63.35%(P<0.05)。2组患者在胃肠道不适、肝肾功能损伤、贫血等方面差异无统计学意义(P>0.05)。结论雷帕霉素联合I125粒子植入联合应用,能有效提高中晚期NSCLC患者的疗效,提高患者KPS、BMI及TTP水平,延长患者生存时间,不良反应少。
Objective To evaluate the clinical efficacy of rapamycin combined with iodine-125 (I125) in the treatment of advanced non-small cell lung cancer (NSCLC). Methods Ninety-two NSCLC patients were randomly divided into control group and trial group, with 46 patients in each group. The control group was given a particle therapy plan according to Particle Implantation Planning System (TPS). I125 was implanted under the guidance of computed tomography (CT) Tumor, the prescription dose of 90 Gy. The experimental group on this basis with rapamycin, each 2 mg, 1 day, 3 weeks for a course of treatment for 4 courses. The CT scan was performed 4 weeks after the end of treatment, and the therapeutic effect was evaluated by RECIST. The KPS, BMI and TTP of the patients after treatment were observed and recorded. The survival and adverse reactions of the two groups were recorded. Results The objective response rate (43.48%) in the experimental group was significantly higher than that in the control group (30.43%, P <0.05). The KPS, BMI and TTP in the two groups were significantly higher than those before treatment (P < 0.01). The above indexes in the experimental group were significantly higher than those in the control group (P <0.05, P <0.01, P <0.05). The median survival time was 17.03 months and the 1-year survival rate was 74.52% The control group was 13.16 months and 63.35% (P <0.05). There was no significant difference in gastrointestinal discomfort, liver and kidney dysfunction, anemia among the two groups (P> 0.05). Conclusion The combination of rapamycin and I125 particle implantation can effectively improve the curative effect of patients with advanced NSCLC, improve the KPS, BMI and TTP level, prolong the survival time of patients with less adverse reactions.