Xiang Zhanwang, Li Guohong, Liu Zhenyin, Huang Jinhua, Zhong Zhihui, Sun Lin, Li Chuanxing, Zhang Funjun
From the State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center (ZX, GL, JH, ZZ, LS, CL, FZ), and Guangzhou Women and Children Health Care Center, Guangzhou, China (ZL).
Medicine (Baltimore). 2015 Dec;94(49):e2249. doi: 10.1097/MD.0000000000002249.
To investigate the safety and effectiveness of computed tomography (CT)-guided I seed implantation for locally advanced nonsmall cell lung cancer (NSCLC) after progression of concurrent radiochemotherapy (CCRT).We reviewed 78 locally advanced NSCLC patients who had each one cycle of first-line CCRT but had progressive disease identified from January 2006 to February 2015 at our institution. A total of 37 patients with 44 lesions received CT-guided percutaneous I seed implantation and second-line chemotherapy (group A), while 41 with 41 lesions received second-line chemotherapy (group B).Patients in group A and B received a total of 37 and 41 first cycle of CCRT treatment. The median follow-up was 19 (range 3-36) months. After the second treatment, the total response rate (RR) in tumor response accounted for 63.6% in group A, which was significantly higher than that of group B (41.5%) (P = 0.033). The median progression-free survival time (PFST) was 8.00 ± 1.09 months and 5.00 ± 0.64 months in groups A and B (P = 0.011). The 1-, 2-, and 3-year overall survival (OS) rates for group A were 56.8%, 16.2%, and 2.7%, respectively. For group B, OS rates were 36.6%, 9.8%, and 2.4%, respectively. The median OS time was 14.00 ± 1.82 months and 10.00 ± 1.37 months for groups A and B, respectively (P = 0.059). Similar toxicity reactions were found in both groups. Tumor-related clinical symptoms were significantly reduced and the patients' quality of life was obviously improved.CT-guided I seed implantation proved to be potentially beneficial in treating localized advanced NSCLC; it achieved good local control rates and relieved clinical symptoms without increasing side effects.
探讨计算机断层扫描（CT）引导下碘-125粒子植入术对同步放化疗（CCRT）后进展的局部晚期非小细胞肺癌（NSCLC）的安全性和有效性。我们回顾性分析了2006年1月至2015年2月期间在我院接受一线CCRT且疾病进展的78例局部晚期NSCLC患者。其中，37例患者共44个病灶接受了CT引导下经皮碘-125粒子植入术及二线化疗（A组），41例患者共41个病灶接受了二线化疗（B组）。A组和B组患者分别接受了37个和41个周期的一线CCRT治疗。中位随访时间为19（3-36）个月。二次治疗后，A组肿瘤反应的总缓解率（RR）为63.6%，显著高于B组（41.5%）（P = 0.033）。A组和B组的中位无进展生存时间（PFST）分别为8.00±1.09个月和5.00±0.64个月（P = 0.011）。A组1年、2年和3年总生存率（OS）分别为56.8%、16.2%和2.7%。B组OS率分别为36.6%、9.8%和2.4%。A组和B组的中位OS时间分别为14.00±1.82个月和10.00±1.37个月（P = 0.059）。两组毒性反应相似。肿瘤相关临床症状显著减轻，患者生活质量明显改善。CT引导下碘-125粒子植入术在治疗局部晚期NSCLC方面具有潜在益处；它实现了良好的局部控制率，缓解了临床症状且未增加副作用。
