Song Jingjing, Fan Xiaoxi, Zhao Zhongwei, Chen Minjiang, Chen Weiqian, Wu Fazong, Zhang Dengke, Chen Li, Tu Jianfei, Ji Jiansong
Department of Interventional Radiology, Zhejiang University Lishui Hospital, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Central Hospital, Lishui, Zhejiang, People's Republic of China.
Onco Targets Ther. 2017 Mar 2;10:1345-1352. doi: 10.2147/OTT.S129903. eCollection 2017.
The objective of this study was to assess the efficacy of computed tomography (CT)-guided I brachytherapy alone in improving the survival and quality of life of patients with unresectable locally advanced non-small-cell lung cancer (NSCLC) after one cycle of first-line chemotherapy.
Sixteen patients with locally advanced NSCLC were treated with CT-guided I brachytherapy after one cycle of first-line chemotherapy (group A). Sixteen patients who received only best supportive care (group B) were matched up with the patients in group A. Primary end point included survival, and secondary end point included assessment of safety, effectiveness of CT-guided I brachytherapy, and improvement in the quality of life.
The two groups were well balanced in terms of age, disease histology, tumor stage, tumor location, and performance status (>0.05). The median follow-up time was 16 months (range, 3-30). The total tumor response rate was 75.0% in group A, which was significantly higher than that in group B (0.0%) (<0.01). The median progression-free survival time was 4.80 months for patients in group A and 1.35 months for patients in group B (<0.001). Kaplan-Meier survival analysis showed that the median survival time of group A was 9.4±0.3 months versus 8.4±0.1 months in group B (=0.013). Tumor-related symptoms of patients were significantly relieved, and the quality of life was markedly improved in group A than in group B.
CT-guided I brachytherapy improved the survival of patients with locally advanced NSCLC and quality of life after one cycle of first-line chemotherapy compared with best supportive care.
本研究的目的是评估在一线化疗一个周期后，计算机断层扫描（CT）引导下的碘-125近距离放射治疗在改善不可切除的局部晚期非小细胞肺癌（NSCLC）患者的生存率和生活质量方面的疗效。
16例局部晚期NSCLC患者在一线化疗一个周期后接受CT引导下的碘-125近距离放射治疗（A组）。16例仅接受最佳支持治疗的患者（B组）与A组患者进行匹配。主要终点包括生存率，次要终点包括安全性评估、CT引导下碘-125近距离放射治疗的有效性以及生活质量的改善情况。
两组在年龄、疾病组织学、肿瘤分期、肿瘤位置和体能状态方面均衡良好（>0.05）。中位随访时间为16个月（范围3 - 30个月）。A组的总肿瘤缓解率为75.0%，显著高于B组（0.0%）（<0.01）。A组患者的中位无进展生存时间为4.80个月，B组患者为1.35个月（<0.001）。Kaplan-Meier生存分析显示，A组的中位生存时间为9.4±0.3个月，而B组为8.4±0.1个月（P = 0.013）。A组患者的肿瘤相关症状明显缓解，生活质量明显高于B组。
与最佳支持治疗相比，CT引导下的碘-125近距离放射治疗在一线化疗一个周期后提高了局部晚期NSCLC患者的生存率和生活质量。
