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碘-125近距离放射治疗联合化疗用于同步放化疗后局部复发的III期非小细胞肺癌

Combination of Iodine-125 brachytherapy and chemotherapy for locally recurrent stage III non-small cell lung cancer after concurrent chemoradiotherapy.

作者信息

Yu Xiaojuan, Li Jin, Zhong Xiaoming, He Jingdong

机构信息

Department of Oncology, Huai'an First People's Hospital, Nanjing Medical University, 6 Beijing Road West, Huai'an, Jiangsu, 223300, China.

出版信息

BMC Cancer. 2015 Oct 6;15:656. doi: 10.1186/s12885-015-1657-3.

Abstract

BACKGROUND

Locally recurrent non-small cell lung cancer (NSCLC) poses a great challenge to physicians. This study aimed to explore the efficacy and safety of the combination of brachytherapy and docetaxel and cisplatin for the treatment of locally recurrent stage III NSCLC.

METHODS

Fifty two patients with locally recurrent stage III NSCLC after concurrent chemoradiotherapy were randomly divided into two groups (n = 26). The patients in experimental group were treated with implantation of radioactive (125)I seeds and DP regimen (docetaxel 60 mg/m(2)/cisplatin 75 mg/m(2)). Patients in control group received DP chemotherapy. The local control rate (LCR), progression-free survival (PFS), and overall response rate (ORR) were defined according to the Response Evaluation Criteria in Solid Tumors (RECIST).

RESULTS

With a median follow-up time of 11 months, PFS and LCR was 8 months (95 % CI: 6.99-9.01 months) vs. 5.5 months (95 % CI: 4.43-6.57 months) (P < 0.05) and 10 months (95 % CI: 8.72-11.28 months) vs. 6.2 months (95 % CI: 5.27-7.13 months) (P < 0.05) in the experimental and control groups, respectively. The ORR did not differ between treatment groups and was noted to be 69.2 % and 57.7 %, respectively (P >0.05). There was no occurrence of severe complications in experimental and control groups.

CONCLUSION

The combination of (125)I brachytherapy and second-line chemotherapy is superior to chemotherapy alone and is an effective and safe therapy for this disease.

TRIAL REGISTRATION NUMBER

ChiCTR-IOR-15006560.

摘要

背景

局部复发性非小细胞肺癌(NSCLC)给医生带来了巨大挑战。本研究旨在探讨近距离放射治疗联合多西他赛和顺铂治疗局部复发性III期NSCLC的疗效和安全性。

方法

52例同步放化疗后局部复发性III期NSCLC患者被随机分为两组(n = 26)。实验组患者接受放射性(125)I粒子植入及DP方案(多西他赛60mg/m²/顺铂75mg/m²)治疗。对照组患者接受DP化疗。根据实体瘤疗效评价标准(RECIST)定义局部控制率(LCR)、无进展生存期(PFS)和总缓解率(ORR)。

结果

中位随访时间为11个月,实验组和对照组的PFS分别为8个月(95%CI:6.99 - 9.01个月)和5.5个月(95%CI:4.43 - 6.57个月)(P < 0.05),LCR分别为10个月(95%CI:8.72 - 11.28个月)和6.2个月(95%CI:5.27 - 7.13个月)(P < 0.05)。治疗组间ORR无差异,分别为69.2%和57.7%(P > 0.05)。实验组和对照组均未发生严重并发症。

结论

(125)I近距离放射治疗联合二线化疗优于单纯化疗,是治疗该疾病的一种有效且安全的疗法。

试验注册号

ChiCTR - IOR - 15006560。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8110/4596375/3ab4125a7c11/12885_2015_1657_Fig1_HTML.jpg

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