Lin Chunlong, Yang Zhi, Liu Qi
Department of Respiratory, Yueyang Municipal Hospital of Hunan Normal University, Yueyang 414000, Hunan, China.
Health Phys. 2023 Oct 1;125(4):273-280. doi: 10.1097/HP.0000000000001714. Epub 2023 Jun 22.
This paper compares the efficacy and adverse effects of iodine-125 ( 125 I) seed implantation and external beam radiotherapy (EBRT) in the treatment of lung cancer as well as impact of the 125 I radiation on the environment around the patients. A total of 40 patients who were admitted with lung cancer to our hospital from October 2017 to October 2018 were enrolled into this study. The patients were randomly assigned into study groups treated with 125 I seed implantation (20 patients) and a control group treated with EBRT (20 patients). The patients were followed up for 6 mo by CT scanning of the tumor size as well as measuring serum carcinoembryonic antigen (CEA), cytokeratin fragment (CYRA21-1), and neurospecific enolase (NSE) levels. The dose rate of 125 I at various distances and times after implantation was also measured. The local tumor control rate was higher in the study group than in the control group. CEA, NSE and CYFRA21-1 significantly decreased from the pre-treatment baseline in both groups (p < 0.05). Side effects of pneumothorax, hemoptysis, chest pain, and leukopenia occurred in the patients treated with 125 I seed implantation. Radiation of the 125 I isotope, which was correlated with the number of implanted 125 I seeds, decreased rapidly in a time- and distance-dependent manner. A lead apron could significantly block radiation of 125 I. Compared to EBRT, brachytherapy with 125 I seed implantation in the lung cancer had a better therapeutic outcome with fewer complications. A lead apron could protect members of patient's family as well as public from 125 I radiation.
本文比较了碘-125（¹²⁵I）粒子植入与外照射放疗（EBRT）治疗肺癌的疗效和不良反应，以及¹²⁵I辐射对患者周围环境的影响。2017年10月至2018年10月我院收治的40例肺癌患者纳入本研究。患者被随机分为¹²⁵I粒子植入治疗组（20例）和EBRT治疗对照组（20例）。通过CT扫描肿瘤大小以及检测血清癌胚抗原（CEA）、细胞角蛋白片段（CYRA21-1）和神经元特异性烯醇化酶（NSE）水平对患者进行6个月的随访。还测量了¹²⁵I植入后不同距离和时间的剂量率。研究组的局部肿瘤控制率高于对照组。两组患者的CEA、NSE和CYFRA21-1均较治疗前基线水平显著下降（p<0.05）。¹²⁵I粒子植入治疗的患者出现气胸、咯血、胸痛和白细胞减少等副作用。¹²⁵I同位素的辐射与¹²⁵I粒子植入数量相关，呈时间和距离依赖性快速下降。铅衣可显著阻挡¹²⁵I的辐射。与EBRT相比，¹²⁵I粒子植入近距离治疗肺癌疗效更好，并发症更少。铅衣可保护患者家属及公众免受¹²⁵I辐射。
