Guo Yongtao,Huo Xiaodong,Huo Bin,Dong Hua,Shi Shuyuan,Zheng Guangjun,Chai Shude,Wang Junjie,Wang Haitao,Zhang Zuncheng.Analysis of prognosis and influencing factors of CT-guided 125I radioactive seed implantation combined with chemotherapy for limited-stage small cell lung cancer[J].Chinese Journal of Radiological Medicine and Protection,2018,38(9):690-695
Analysis of prognosis and influencing factors of CT-guided 125I radioactive seed implantation combined with chemotherapy for limited-stage small cell lung cancer
Received:January 22, 2018  
DOI:10.3760/cma.j.issn.0254-5098.2018.09.010
KeyWords:125I seeds  Limited-stage  Small cell lung cancer(SCLC)  Curative effect analysis  Prognostic
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Author NameAffiliationE-mail
Guo Yongtao Department of Nuclear Medicine, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Huo Xiaodong Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Huo Bin Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Dong Hua Department of Nuclear Medicine, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Shi Shuyuan Department of Thoracic Surgery, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Zheng Guangjun Department of Thoracic Surgery, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Chai Shude Department of Thoracic Surgery, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Wang Junjie Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, China  
Wang Haitao Department of Oncology, Second Hospital of Tianjin Medical University, Tianjin 300211, China  
Zhang Zuncheng Department of Nuclear Medicine, Second Hospital of Tianjin Medical University, Tianjin 300211, China zhangzuncheng@sina.com 
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Abstract::
      Objective To evaluate the clinical efficacy and prognostic factors of limited-stage small cell lung cancer (LS-SCLC)treated with 125I radioactive seed implantation guided by CT combined with systemic chemotherapy. Methods A total of 128 limited-stage small cell lung cancer patients were treated with 125I radioactive seed implantation combined with chemotherapy from Jun 2008 to Jun 2012 in Tianjin Medical University Second Hospital.The χ2 test was used to analyze the influencing factors of short-term efficacy. Survival rate was calculated by Kaplan-Meier method, single factor analysis was performed by Log-rank, and multivariate analysis was performed by Cox proportional hazard model. Results Totally 128 patients finished the treatment. The overall response rate was 86.7% (111/128) after 6 months of treatment. The 1-, 2-and 3-year overall survival rate was 77.9%, 39.8%and 28.0%, respectively, and the median survival time was 21.0 months. The univariate analysis showed that the following factors were main prognostic factors:age, performance status (PS), hemoglobin ≥ 120 g/L before treatment, smoking index, the maximum diameter of tumor, neuron-specific enolase before treatment, subscribe for prophylactic cranial irradiation (PCI), number of chemotherapy cycle, chemotherapy response, prescribed dose (PD), postoperation dose covering 100% volume (D100), remedial model. multivariate analysis revealed that age, PS, hemoglobin ≥ 120 g/L before treatment and PD, the maximum diameter of tumor, number of chemotherapy cycle, chemotherapy response, and remedial model were the independent prognostic factors for survival. 29 patients of 128 suffered from aerothorax and the incidence rate of aerothorax was 27.7%. Totally 16 patients occurred hemoptysis and theincidence rate was 12.5%. Conclusions 125I radioactive seed implantation therapy showed good effecacy in the treatment of LS-SCLC. Age, PS, hemoglobin ≥ 120 g/L before treatment, the maximum diameter of tumor, number of chemotherapy cycle, chemotherapy response, and remedial model might be the main prognostic factors for LS-SCLC patients.
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