The Clinical Efficacy Of ¹²⁵I Seed Implantation In The Treatment Of Non-small Cell Lung Cancer And The Changes Of CEA And CYFRA21-1 Before And After Treatment

Objective The purpose of this study is to evaluate the changes of CEA and CYFRA21-1 levels and the clinical effect of CT guided ¹²⁵I seed implantation combined with bronchial artery infusion chemotherapy in the treatment of advanced non-small cell lung cancer?NSCLC?.Materials and methods The clinical data of 87 patients with NSCLC who could not be operated on in our hospital from January 2013 to January 2017 were analyzed,including 47 males and 40 females,aged from 50 to 87 years,with an average age of 66 years.They were divided into two groups: the combined group(n=42,treated with bronchial artery perfusion combined with ¹²⁵I seed implantation)and perfusion group?n=45,treated with bronchial artery perfusion chemotherapy alone?.The pathological types were squamous cell carcinoma?36 cases?and adenocarcinoma?51 cases?.Before the treatment,there was no statistical difference in the age,pathological classification,TNM stage and other clinical data between the two groups?P > 0.05?.The dynamic changes of serum CEA and CYFRA21-1 concentration and their effects on clinical treatment were compared between the two groups.Results The total effective rates of the two groups were 35.7%,54.7%,66.6%,71.4%and 15.6%,28.8%,38.6% and 39.3% respectively.The total remission rate of the combined group was significantly higher than that of the perfusion group?P < 0.05?.There was no significant difference in serum CEA and CYFRA21-1 between the combined group and the perfusion group?P > 0.05?;the 3-year cumulative survival rate of the combined group was higher than that of the perfusion group??² = 11.028,P =0.001?,and the median survival time was 20 months?95% CI: 14.92-25.08?and 15 months?95% CI: 13.16-16.84?,respectively.The median progression free survival time was 11 months?95% CI: 8.29-13.71?and 7 months?95% CI: 5.12-8.88?,respectively.The overall survival rate of CEA decreased group was higher than that of CEA increased group??² = 6.935,P = 0.008?.The median survival time was 18 months?95%CI: 16.01-19.93?and 8 months?95% CI: 5.45-10.55?,respectively.The overall survival rate of CYFRA21-1 decreased group was higher than that of CYFRA21-1 increased group??²= 4.264,P = 0.039?,and the median survival time was 19 months?95% CI:16.94-21.06.93?and 12 months?95% CI: 8.33-15.67?,respectively.The serum CEA and CYFRA21-1 levels in the combined group were significantly lower than those in the perfusion group?P < 0.05?.According to the changes of CEA and CYFRA21-1before and after treatment,they were divided into increasing group and decreasing group.The effective rate of CEA and CYFRA21-1 decreasing group was significantly higher than that of increasing group?P < 0.001?.The median survival time of the combined group and the perfusion group was 20 months and 15 months respectively,and the median progression free survival time was 11 months and 7 months respectively.The survival rate of the combined group was significantly higher than that of the perfusion group??² = 11.028,P = 0.001?.Conclusion ¹²⁵I seed implantation combined with bronchial artery infusion chemotherapy in the treatment of advanced NSCLC can significantly reduce the tumor size and serum CEA,CYFRA21-1 concentration,improve the survival rate and clinical symptoms of patients,and the dynamic changes of tumor markers can predict the prognosis of patients,which has important clinical value.