Oligorecurrence Non-small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography-Guided 125I Seed Implantation vs. Second-Line Chemotherapy
Oligorecurrence Non-small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography-Guided 125I Seed Implantation vs. Second-Line Chemotherapy
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DOI：
10.3389/fonc.2020.00470
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发表时间：
2020-04-15
影响因子：
4.7
通讯作者：
Guo, Jin-He
中科院分区：
文献类型：
--
作者：
Wang, Hao;Lu, Jian;Guo, Jin-He
目的：比较CT引导下I-125粒子植入与二线化疗治疗一线化疗失败后少复发非小细胞肺癌的疗效和安全性。方法：回顾性分析2013年1月至2018年7月两家机构一线化疗失败后少复发非小细胞肺癌患者的资料。共有53例接受I-125粒子植入或二线化疗的患者符合本研究的条件。在A组中，25例患者，84个病灶，接受CT引导下永久性I-125粒子植入，而在B组中，28例患者，96个病灶，接受二线化疗。结果是衡量疾病控制率，总生存率，生活质量和并发症。结果：中位随访期为13个月（范围，5-42个月）。治疗后6个月，A组疾病控制率为70.8%，高于B组的42.3%（P = 0.042）。A组中位总生存期为12.8个月（95%可信区间为10.5-15.1个月），B组为15.2个月（95%可信区间为12.2-18.2个月），两组间无显著性差异（P = 0.847）。自治疗4个月起，A组Karnofsky行为量表评分无下降者多于B组（P < 0.05）。A组3级以上并发症尤其是血液学毒性的发生率明显低于B组（P < 0.05）。结论：放射性I-125粒子植入在一线化疗失败后少数复发的非小细胞肺癌患者中是安全可行的，与二线化疗相比，线化疗。
Purpose: To compare the efficacy and safety of computed tomography (CT)-guided I-125 seed implantation with second-line chemotherapy in treatment of oligorecurrence non-small cell lung cancer after failure of first-line chemotherapy.Methods: Data of oligorecurrence non-small cell lung cancer patients after failure of first-line chemotherapy at two institutions were retrospectively reviewed from January 2013 to July 2018. A total of 53 patients who received the treatment of I-125 seed implantation or second-line chemotherapy were eligible for this study. In group A, 25 patients, 84 lesions, received CT-guided permanent I-125 seed implantation, whereas in group B, 28 patients, 96 lesions, received second-line chemotherapy. The outcomes were measured in terms of disease control rate, overall survival, quality of life, and complications.Results: The median follow-up period was 13 months (range, 5-42 months). Disease control rate in group A was higher than that in group B (70.8 vs. 42.3%, P = 0.042) at 6 months after treatment. The median overall survival was 12.8 months (95% confidence interval, 10.5-15.1 months) in group A and 15.2 months (95% confidence interval, 12.2-18.2 months) in group B, with no significant difference (P = 0.847). Since the fourth month, the number of patients in group A with a non-decreasing Karnofsky Performance Scale score was more than that in group B (P < 0.05). The incidence of grade 3 or higher complications especially hematologic toxicity in group A was significantly lower than that in group B (P < 0.05).Conclusion: Radioactive I-125 seed implantation is safe and feasible in selected non-small cell lung cancer patients with oligorecurrence after failure of first-line chemotherapy and seems to provide a better long-term quality of life in these patients compared with second-line chemotherapy.