切换至 "中华医学电子期刊资源库"

中华胸部外科电子杂志 ›› 2017, Vol. 04 ›› Issue (01) : 38 -42. doi: 10.3877/cma.j.issn.2095-8773.2017.01.08

所属专题: 文献

论著

125I粒子永久植入联合实时测温射频消融治疗肺癌效果分析
毛宇1,(), 杨秀彦1, 郭伟1, 黎明1, 张文华1   
  1. 1. 010030 内蒙古呼和浩特市第一医院胸外科
  • 收稿日期:2016-01-05 出版日期:2017-02-28
  • 通信作者: 毛宇
  • 基金资助:
    内蒙古自治区政府科技攻关项目和内蒙古自治区医药卫生科技攻关项目(20100501)

Clinical effect of permanent implantation of 125I particles and radiofrequency ablation with real-time temperature measurement for treatment of patients with lung cancer

Yu Mao1,(), Xiuyan Yang1, Wei Guo1, Ming Li1, Wenhua Zhang1   

  1. 1. Department of Chest Surgery , The First Hospital of Hohhot , Hohhot 010030 , China
  • Received:2016-01-05 Published:2017-02-28
  • Corresponding author: Yu Mao
  • About author:
    Corresponding author: Mao Yu, Email:
引用本文:

毛宇, 杨秀彦, 郭伟, 黎明, 张文华. 125I粒子永久植入联合实时测温射频消融治疗肺癌效果分析[J/OL]. 中华胸部外科电子杂志, 2017, 04(01): 38-42.

Yu Mao, Xiuyan Yang, Wei Guo, Ming Li, Wenhua Zhang. Clinical effect of permanent implantation of 125I particles and radiofrequency ablation with real-time temperature measurement for treatment of patients with lung cancer[J/OL]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2017, 04(01): 38-42.

目的

探讨125I粒子永久植入联合实时测温射频消融治疗中晚期非小细胞肺癌(NSCLC)的临床效果。

方法

收集2012年10月至2015年1月在内蒙古呼和浩特市第一医院胸外科未接受外科手术治疗的中晚期NSCLC患者98例,根据患者意愿分为联合治疗组(n=45)和常规治疗组(n=53)。联合治疗组采用125I粒子永久植入联合实时测温射频消融治疗,并于术后3个月配合使用化疗方案(培美曲赛+卡铂);常规治疗组直接使用化疗方案(培美曲赛+卡铂)。术后1周和1、3、6、12个月复查增强CT明确临床疗效。采用欧洲癌症研究与治疗组织肺癌患者生命质量测定特异性模块(EORQLQ—LCl3中文版)、肺癌患者的总生存质量评价表和生存时间比较两组患者治疗前和治疗后的差异。

结果

联合治疗组患者治疗后均未出现严重并发症,术后复查增强CT,可见病灶部位于术后1个月开始强化逐渐减弱,3~6个月出现125I粒子位置缓慢聚集,病灶逐步固化坏死,形成空洞,去血管征象和凝固性坏死明显。随访7~24个月,联合治疗组生存率88.9%,常规治疗组生存率49.1%。治疗前,两组患者的EORQLQ—LCl3和总生存质量比较,差异均无统计学意义(P>0.05);治疗后,两组患者的EORQLQ—LCl3和总生存质量评分均较治疗前明显改善(P<0.05);且联合治疗组在EORQLQ—LCl3评分及总生存质量评分均明显优于常规治疗组(P<0.05)。联合治疗组患者的平均生存时间为(18.4±5.8)个月,显著优于常规治疗组的(10.9±4.2)个月(t=5.763,P<0.05)。

结论

125I粒子永久植入联合实时测温射频消融治疗肺癌是一种简单、安全、微创、有效的方法,同时125I粒子永久植入联合实时测温射频消融治疗与化疗有机结合,能很好地改善患者的生活质量并延长生存期。

Objective

To investigate the clinical effect of permanent implantation of 125I particles and radiofrequency ablation with real-time temperature measurement for the treatment of patients with non-small cell lung cancer (NSCLC).

Methods

A total of 98 patients with mid-late stage NSCLC without surgical treatment in Department of Chest Surgery, The First Hospital of Hohhot between October 2012 and January 2015 were enrolled, according to the patient will joint were divided into combined treatment group (n=45) and convention treatment group (n=53). Patients in combined treatment group underwent permanent implantation of 125I particles and radiofrequency ablation with real-time temperature measurement, and received chemotherapy (pemetrexed+ carboplatin) 3 months after operation. Patients in conventional treatment group were just managed with chemotherapy(pemetrexed+ carboplatin). The enhanced CT was performed to determine the clinical effects one week and 1, 3, 6 and 12 months after operation. The differences between two groups before and after treatment were analyzed by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire—Lung Cancer 13 Chinese Edition (EORQLQ—LCl3 Chinese Edition), Quality of Survival Assessment Table for Lung Cancer and survival time.

Results

No severe complications occurred after treatment in combined treatment group. Postoperative enhanced CT indicated that the focus gradually weakened 1 month after operation, the locations of 125I particles aggregated 3 to 6 months after operation, solidification and necrosis of focus then gradually took place, blank cavity formed, and obvious devascularization and coagulative necrosis happened. Patients were followed up for 7 to 24 months, the survival of combined treatment group was 88.9%, and that of conventional treatment group was 49.1%. There was no significant difference in EORQLQ—LCl3 and total quality of survival before treatment between two groups(P>0.05). After treatment, EORQLQ—LCl3 and total quality of survival scores in two groups significantly improved (P<0.05); and EORQLQ—LCl3 and total quality of survival scores in combined treatment group were much better than those in conventional treatment group (P<0.05). The mean survival time in combined treatment group was (18.4±5.8) months, which was significantly longer than that in conventional treatment group [(10.9±4.2) months](t=5.763, P<0.05).

Conclusions

It is a simple, safe, minimally invasive and effective method to treat lung cancer with permanent implantation of 125I particles and radiofrequency ablation with real-time temperature measurement, which can improve the quality of life and prolong patient survival in combination with conventional chemotherapy.

表1 两组患者总生存质量评价和生命质量比较(分,±s)
表2 两组患者治疗后总生存质量评价和生命质量比较(分,±s)
1
Tan J, Heriot AG, Mackay J, et al. Prospective single-arm study of intraoperative radiotherapy for locally advanced or recurrent rectal cancer[J]. J Med Imaging Radiat Oncol, 2013, 57(5): 617-625.
2
吴浩明,吕军,胡卫列,等.经直肠穿刺125I粒子植入联合内分泌治疗局部晚期前列腺癌的临床疗效[J].中华男科学杂志,2013, 19(7): 617-621.
3
yoshioka Y. Current staue and perspectives of brachytherapy for prostate cancer [J].Int J Clin Oncol, 2009,14(1):31-36.
4
程晓麟,周德明,吕丽萍. EORTC QLQ问卷表评估影响肺癌患者生命质量的相关因素[J].中国肺癌杂志,2004,3: 230-235.
5
郑良成,田辉荣,谢培增. 医学生存质量评估[M]. 北京:军事医学科学出版社,2005,169-174.
6
林世寅,李瑞英. 现代肿瘤热疗学[M]. 北京:学苑出版社,1997.
7
毛宇. 经皮放射粒子植入术联合化疗治疗肺癌29例分析[J].内蒙古医学杂志,2010,10:879-883.
8
Mosleh Shirazi MA, Faghihi R, Siavashpour Z, et al. Independent evaluation of an in-house brachytherapy treatment planning system using simulation, measurement and calculation methods[J]. J Appl Clin Med Phys, 2012,13(2):3687.
9
Dauer LT, Thornton C, Miodownik D, et al. Radioactive seed localization with 125I for nonpalpable lesions prior to breast lumpectomy and/or excisional biopsy: methodology, safety, and experience of initial year[J]. Health Phys, 2013,105(4):356-365.
10
田建明.CT引导下经皮肿瘤消融术应用现状[J].介入放射学杂志,2007,16(12):793-795.
11
毛宇.非小细胞肺癌的射频消融治疗肺癌35例分析.[J].中国癌症防治杂志,2011,1(456-459).
12
赵健,吴一龙,王远东,等.射频消融联合放化疗治疗局部晚期非小细肺癌[J]。肿瘤防治研究,2004,8(31):495-497.
13
Dauer LT, Thornton C, Miodownik D, et al. Radioactive seed localization with 125I for nonpalpable lesions prior to breast lumpectomy and/or excisional biopsy: methodology, safety, and experience of initial year[J]. Health Phys, 2013,105(4):356-365.
14
Matsuoka J, Yashiro M, Doi Y, et al. Hypoxia stimulates the EMT of gastric cancer cells through autocrine TGFbeta signaling[J]. PLoS One,2013,8(5):e62310.
15
张骏,高宏,李力军. CT引导射频消融联合化疗粒子局部植入治疗肺癌:附62例报告[J].山东医药,2008,48(24)61-62.
16
Zalcman G, Bergot E, Lechapt E. Update on nonsmall cell lung cancer[J]. Eur Respir Rev,2010,19(117):173-185.
17
Cosgrove SE, Ristaino P, Caston-Gaa A, et al. Caveat emptor: the role of suboptimal bronchoscope repair practices by a third-party vendor in a pseudo-outbreak of pseudomonas in bronchoalveolar lavage specimens[J]. Infect Control Hosp Epidemiol,2012,33(3):224-229.
[1] 洪玮, 叶细容, 刘枝红, 杨银凤, 吕志红. 超声影像组学联合临床病理特征预测乳腺癌新辅助化疗完全病理缓解的价值[J/OL]. 中华医学超声杂志(电子版), 2024, 21(06): 571-579.
[2] 常小伟, 蔡瑜, 赵志勇, 张伟. 高强度聚焦超声消融术联合肝动脉化疗栓塞术治疗原发性肝细胞癌的效果及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 56-59.
[3] 杨建波, 马欢, 黄小梅, 刘华柱. 结肠镜辅助下EMR、CSP和RFA术治疗直径<1cm结直肠息肉的疗效和安全性比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 76-79.
[4] 李代勤, 刘佩杰. 动态增强磁共振评估中晚期低位直肠癌同步放化疗后疗效及预后的价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 100-103.
[5] 许杰, 李亚俊, 冯义文. SOX新辅助化疗后腹腔镜胃癌D2根治术与常规根治术治疗进展期胃癌的近期随访比较[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 647-650.
[6] 薛庆, 施赛叶, 徐雅文, 盛夏, 张芹芹. 追踪方法学联合失效模式与效应分析在膀胱灌注化疗患者中的应用[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 553-559.
[7] 臧宇, 姚胜, 朱新勇, 戎世捧, 田智超. 低温等离子射频消融治疗腹壁疝术后补片感染的临床效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 687-692.
[8] 张昊, 潘卫东. 胰腺癌新辅助化疗后可切除性评估现状及进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(05): 629-633.
[9] 赵磊, 刘文志, 林峰, 于剑, 孙铭骏, 崔佑刚, 张旭, 衣宇鹏, 于宝胜, 冯宁. 深部热疗在改善结直肠癌术后辅助化疗副反应及生活质量中的作用研究[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 488-493.
[10] 韩加刚, 王振军. 梗阻性左半结肠癌的治疗策略[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 450-458.
[11] 石阳, 于剑锋, 曹可, 翟志伟, 叶春祥, 王振军, 韩加刚. 可扩张金属支架置入联合新辅助化疗治疗完全梗阻性左半结肠癌围手术期并发症分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 464-471.
[12] 梁轩豪, 李小荣, 李亮, 林昌伟. 肠梗阻支架置入术联合新辅助化疗治疗结直肠癌急性肠梗阻的疗效及其预后的Meta 分析[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 472-482.
[13] 张颖, 赵鑫, 陈佳梅, 李雁. 术前化疗对CRS+HIPEC 治疗腹膜假黏液瘤预后影响的meta 分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 826-835.
[14] 蔡晓雯, 李慧景, 丘婕, 杨翼帆, 吴素贤, 林玉彤, 何秋娜. 肝癌患者肝动脉化疗栓塞术后疼痛风险预测模型的构建及验证[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 722-728.
[15] 张梦婷, 穷拉姆, 色珍, 李逸群, 德庆旺姆. 西藏地区藏族乳腺癌新辅助化疗的真实世界研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(05): 441-446.
阅读次数
全文


摘要