Clinical Value Of CT-guided ¹²⁵I Particle Combination Chem Otherapy For Non-small Cell Lung Cancer

Objective:To evaluate the efficacy and safety of CT-guided ¹²⁵I radioactive seed implantation combined with chemotherapy in the treatment of locally advanced non-small cell lung cancer（NSCLC）.Mehods:From January 2013 to January 2018,55 patients with stage IIb-IIIa NSCLC admitted to the First People’s Hospital of Lianyungang were prospective randomized controlled clinical trials.All patients enrolled in the pathology were non-small cell lung cancer;all patients enrolled due to poor cardiopulmonary function intolerance surgery or refused surgery.There was no statistical difference in preoperative general clinical data between the two groups.In the experimental group,28 patients were treated with CT-guided ¹²⁵I radioactive seed implantation combined with（paclitaxel-cisplatin）chemotherapy for 4 courses of systemic intravenous chemotherapy;27 patients in the control group underwent three-dimensional conformal radiotherapy（3D-CRT）combined with TP program systemic intravenous chemotherapy.Patients in the experimental group underwent CT-guided ¹²⁵I radioactive seed implantation,and the TPS dose was verified immediately after the operation while dose-deficient area was replanted.The chemotherapy regimen was intravenous chemotherapy on the third day after surgery.Thoracic enhanced CT was performed in the third and sixth months after operation.The remission of the target lesion,the presence or absence of particle displacement and radiation injury were compared.The tumor markers such as CEA and CYFRA21-1 in the serum were reviewed at 3 and 6 months after operation,comparative analysis of its differences.Results:In the experimental group of 28 patients,4 patients were immediately replanted twice.The preoperative planned peripheral dose（mPD）was（132.50±12.66）Gy,and the average dose of 90%of the target volume after surgery（dose delivered to90%GTV,D90）is（134.57±12.14）Gy,D₉₀>mPD,and the average absorbed dose of OAR is within the threshold range,in line with the TPS plan.The total effective rates of local control in the 3rd and 6th postoperative groups were 89.29（25/28）,66.67%（18/27）and 96.43%（27/28）,74.07%（20/27）,respectively.The difference was statistically significant（χ2 values were 4.123 and 5.526,respectively,P<0.05）.Experimental group PFS（Progress Free Survival,progression-free survival）was 17.8（10-69,95%CI:13.8-21.8）months,the PFS of the control group was 15.8（6-57,95%CI:12.4 to 19.2）months.There was no significant difference in median PFS and1-year PFS between the two groups（χ2 values were 0.917 and 0.100,respectively,P>0.05）.The CEA and CYFRA21-1 in the 3rd month after treatment were significantly lower than the preoperative levels in the two groups.The difference was statistically significant（t.13.418 and 2.243,respectively,P<0.05）.The experimental group received CEA 6 months after operation.Compared with 3 months after operation,there was no significant difference between（7.13±2.48）ng/mL and the third month（t=0.409,P>0.05）.After 6 months,the experimental group CYFRA21-1and the control group CEA and CYFRA21-1 were higher than those in the third month,which were（3.01±0.71,9.01±3.05,3.10±0.67）ng/mL,respectively.Compared with the third month,the experiment was statistically different（t=4.537respectively）.2.243 and 2.673,both P<0.05).Conclusion:The efficacy and safety of CT-guided ¹²⁵I radioactive particles combined with chemotherapy for locally advanced and unresectable NSCLC is superior to that of concurrent radiotherapy combined with chemotherapy.