Analysis of Efficacy of Radiotherapy and 5-FU Slow Release Particles in Treating Non-small Cell Lung Cancer
|School||Dalian Medical University|
|Keywords||Fluorouracil release agent Radiotherapy Non-small cell lung cancer|
Background and Purpose: Lung cancer is now recognized as a threat to human health and life of one of the most important cancer, lung cancer incidence in many countries rank malignancies. Classification of lung cancer, non-small cell lung cancer (nor-small cell lung cancer NSCLC) accounting for about 80% -85% of lung cancer. Currently, surgery is still the primary non-small cell lung cancer treatment, especially early lung cancer, however, the treatment, the patient has lost about three-quarters of surgical treatment. For no longer testify in patients with surgical treatment, radiotherapy is the most important means of local treatment. Research data show that the most important factor affecting patient survival is local control rate; however, in the past often conventional radiotherapy techniques following limitations exist: ⑴ irradiation target range is difficult to accurately determine because of the extent of tumor invasion is difficult to estimate; ⑵ treatment the tumor moves up and down with respiration; ⑶ irradiation target to be protected hazard exists around tissues and organs, such as normal lung tissue, spinal cord and heart, the presence of the above limitations, making possible to significantly improve the conventional radiotherapy techniques NSCLC effect. In recent years, three-dimensional conformal (3D-CRT) and three-dimensional conformal intensity modulated radiation therapy (IMRT) as the representative of precise radiotherapy equipment makes the emergence of the status of radiation therapy significantly improved, and its main advantage is not only significantly increased the target conformal and the target and the surrounding normal tissue dose gradient significantly increased, to better focus on the dose irregular tumor area, thereby surrounding vital tissues and organs are better protected, but radiation therapy alone lung cancer The control is still far from ideal, so in recent years in the treatment of non-small cell lung cancer is particularly advanced non-small cell lung cancer is more emphasis on comprehensive treatment, from the previous single mode of treatment, into a comprehensive treatment model and sequential therapy . In this paper, the combination group (sustained release particles of chemotherapy combined with radiation therapy) and control group (radiotherapy group) to illustrate the efficacy and side effects of sustained efficacy of chemotherapy combined with radiation particles, toxic side effects and feasibility. Methods: October 2007 to February 2009 our department treated without surgical indications or refuse surgical treatment of 38 cases of non-small cell lung cancer, 38 patients were confirmed by pathology or cytology diagnosis of NSCLC, including 26 males , Female 12 cases, with a median age of 61.8 years (41 years a 77-year-old); 19 cases of squamous cell carcinoma, adenocarcinoma, 14 cases, 5 cases of squamous carcinoma; according to TNM clinical staging criteria, Ⅰ - Ⅱ 6 cases, Ⅲ a of 17 cases, Ⅲ b stage (except for pericardial effusion, malignant pleural effusion) in 15 cases, the inclusion criteria for patients expected survival of more than six months, unable or unwilling to undergo surgery were randomly divided into two groups, divided particles combined with chemotherapy radiotherapy group (combination group) and radiotherapy alone group (control group), the joint group of application localized lesions implanted particles release chemotherapy combined three-dimensional conformal radiotherapy, radiotherapy alone over the same period the control group, two groups were compared the efficacy and toxicity reaction. Particle chemotherapy combined group of local human fluorine implantation Ann 500mg-1000mg, about five days after chemotherapy particles implanted tumors by radiation therapy, a single dose of 1.8-2.0Gy, irradiated five times a week, with a total dose of 59.4-60Gy ; the control group underwent radiotherapy alone with the combination group. Results: 38 patients were successfully completed treatment, the combined group two cases intraoperative pneumothorax, lung compression is less than 30%, three days after the self-absorbed, one case of intraoperative hemoptysis, after appropriate application of hemostatic symptom relief, all after the end of treatment month follow-up before March 1, after every 3-6 months later CT, follow-up results suggest that the tumor reduced to varying degrees, evaluated after 6 months of treatment, the combination group CR 5 例, PR 10 例, NC 3 例, PD 0 cases, the total effective (CR PR) 83.3%, control group CR 3 例, PR 8 例, NC 7 例, PD 2 cases, the total efficiency (CR PR) 55.0%, compared with the two groups had significant difference (P lt ; 0.05), the joint group, the total effective rate was 83.3% higher than 55.0%. Follow-up, 2-year survival rates were 88.9% and the combined group, 61.1% in the control group were 60.0%, 30.0% in the second group, the difference was statistically significant (P lt; 0.05). Conclusion: the intralesional fluorouracil sustained release implant, not only to improve the drug concentration within the tumor and prolong drug action time, and avoids the use of oral or intravenous administration to give a common side effect of chemotherapy drugs, the reason is that the drug into the blood vessels volume is very small, less than a common chemotherapy drug induced toxicity concentrations. Applied Radiation therapy with fluorouracil release agent combination therapy do not want surgery or inoperable non-small cell lung cancer patients, no significant side effects in the case of the combination group compared with the control group significantly improved efficacy, indicating fluorouracil sustained-release agent not only for radiation therapy There sensitizing effect, and that such combination therapy also has a less invasive, relatively safe and low complication rate and other characteristics, the current is a comprehensive treatment of non-small cell lung cancer is one effective means.